Korean J Anesthesiol.  2017 Jun;70(3):341-344. 10.4097/kjae.2017.70.3.341.

Non-intubated thoracoscopic surgery for decortication of empyema under thoracic epidural anesthesia: a case report

• Moon EJ
• Go YJ
• Chung JY
• Yi JW

• KMID: 2382752
• DOI: http://doi.org/10.4097/kjae.2017.70.3.341

Abstract

General anesthesia is the main strategy for almost all thoracic surgeries. However, a growing body of literature has reported successful cases of non-intubated thoracic surgery with regional anesthesia. This alternative strategy not only prevents complications related to general anesthesia, such as lung injury, incomplete re-expansion and intubation related problems, but also accords with trends of shorter hospital stay and lower overall costs. We experienced a successful case of non-intubated thoracoscopic decortication for a 68-year-old man who was diagnosed as empyema while the patient kept spontaneously breathing with moderate sedation under thoracic epidural anesthesia. The patient showed a fast recovery without concerns of general anesthesia related complications and effective postoperative analgesia through thoracic epidural patient-controlled analgesia device. This is the first report of non-intubated thoracoscopic surgery under thoracic epidural anesthesia in Korea, and we expect that various well designed prospective studies will warrant the improvement of outcomes in non-intubated thoracoscopic surgery.

Keyword

Non-intubated; Thoracic epidural anesthesia; Thoracoscopic surgery

MeSH Terms

Aged
Analgesia
Analgesia, Patient-Controlled
Anesthesia, Conduction
Anesthesia, Epidural*
Anesthesia, General
Conscious Sedation
Empyema*
Humans
Intubation
Korea
Length of Stay
Lung Injury
Prospective Studies
Respiration
Thoracic Surgery
Thoracoscopy*