Post-thoracotomy analgesia
This article describes different strategies and evidence base for their use. (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Desimir Mijatovic Tarun Bhalla Ibrahim Farid Source Type: research

Impact of regional analgesia techniques on the long-term clinical outcomes following thoracic surgery
Alaa M Khidr, Mert Senturk, Mohamed R El-TahanSaudi Journal of Anaesthesia 2021 15(3):335-340 Continuous monitoring of clinical outcomes after thoracotomy is very important to improve medical services and to reduce complications. The use of regional analgesia techniques for thoracotomy offers several advantages in the perioperative period including effective pain control, reduced opioid consumption and associated side effects, enhanced recovery, and improved patient satisfaction. Postthoracotomy complications, such as chronic postthoracotomy pain syndrome, postthoracotomy ipsilateral shoulder pain, pulmonary complications...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Alaa M Khidr Mert Senturk Mohamed R El-Tahan Source Type: research

Restricted, optimized or liberal fluid strategy in thoracic surgery: A narrative review
Marc Licker, Andres Hagerman, Benoit Bedat, Christoph Ellenberger, Frederic Triponez, Raoul Schorer, Wolfram KarenovicsSaudi Journal of Anaesthesia 2021 15(3):324-334 Perioperative fluid balance has a major impact on clinical and functional outcome, regardless of the type of interventions. In thoracic surgery, patients are more vulnerable to intravenous fluid overload and to develop acute respiratory distress syndrome and other complications. New insight has been gained on the mechanisms causing pulmonary complications and the role of the endothelial glycocalix layer to control fluid transfer from the intravascular to the...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Marc Licker Andres Hagerman Benoit Bedat Christoph Ellenberger Frederic Triponez Raoul Schorer Wolfram Karenovics Source Type: research

Inhalational versus intravenous anesthetics during one lung ventilation in elective thoracic surgeries: A narrative review
Swapnil Parab, Sheetal Gaikwad, Saratchandra MajetiSaudi Journal of Anaesthesia 2021 15(3):312-323 The anesthesia regimen used during one lung ventilation (OLV) carry the potential to affect intra-operative course and post-operative outcomes, by its effects on pulmonary vasculature and alveolar inflammation. This narrative review aims to understand the pathophysiology of acute lung injury during one lung ventilation, and to study the effects of inhalational versus intravenous anaesthetics on intraoperative and post-operative outcomes, following thoracic surgery. For this purpose, we independently searched 'PubM...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Swapnil Parab Sheetal Gaikwad Saratchandra Majeti Source Type: research

Difficult lung separation. An insight into the challenges faced during COVID-19 pandemic
Alaa M Khidr, Mohamed R El TahanSaudi Journal of Anaesthesia 2021 15(3):300-311 Difficult lung isolation or separation in patients undergoing thoracic surgery using one-lung ventilation might be attributed to upper airway difficulty or abnormal anatomy of the lower airway. Additionally, adequate deflation of the surgical lung can impair surgical exposure. The coronavirus disease 2019 (COVID-19) has a harmful consequence for both patients and anesthesiologists. Management of patients with difficult lung isolation can be challenging during the COVID-19 pandemic. Careful planning and preparation, preoperative routine testing...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Alaa M Khidr Mohamed R El Tahan Source Type: research

Anesthesia for thoracic surgery in infants and children
Teresa M Murray-Torres, Peter D Winch, Aymen N Naguib, Joseph D TobiasSaudi Journal of Anaesthesia 2021 15(3):283-299 The management of infants and children presenting for thoracic surgery poses a variety of challenges for anesthesiologists. A thorough understanding of the implications of developmental changes in cardiopulmonary anatomy and physiology, associated comorbid conditions, and the proposed surgical intervention is essential in order to provide safe and effective clinical care. This narrative review discusses the perioperative anesthetic management of pediatric patients undergoing noncardiac thoracic surgery, be...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Teresa M Murray-Torres Peter D Winch Aymen N Naguib Joseph D Tobias Source Type: research

Double lumen tube: Size and insertion depth
Abdelazeem A EldawlatlySaudi Journal of Anaesthesia 2021 15(3):280-282 Double lumen tubes (DLTs) are most commonly used to achieve one lung ventilation (OLV) in most thoracic surgical procedures unless contraindicated. Left-sided DLT (LDLT) is most commonly used nowadays for most thoracic surgical procedures. Though, the use of LDLT dates long back in history, two clinical and technical issues are yet to be resolved. The first issue is the ideal size of DLT which is defined as that which provides near-complete seal of the bronchial lumen without cuff inflation. There are no guidelines in literature which help in selecting...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Abdelazeem A Eldawlatly Source Type: research

Lung separation in adult thoracic anesthesia
Isabelle Huybrechts, Turgay Tuna, Laszlo L SzegediSaudi Journal of Anaesthesia 2021 15(3):272-279 Thoracic anesthesia is mainly the world of OLV during anesthesia. The indications for OLV, classified as absolute or relative are more representative of the new concepts in OLV: It includes either the separation or the isolation of the lungs. Modern DLTs are most widely employed worldwide to perform OLV including the concept of one lung separation. Endobronchial blockers are a valid alternative to DLTs, and they are mandatory in the education of lung separation and in case of predicted difficult airways as they are the safest...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Isabelle Huybrechts Turgay Tuna Laszlo L Szegedi Source Type: research

How can we minimize the risks by optimizing patient & #39;s condition shortly before thoracic surgery ?
Christoph Ellenberger, Raoul Schorer, Benoit Bedat, Andres Hagerman, Frederic Triponez, Wolfram Karenovics, Marc LickerSaudi Journal of Anaesthesia 2021 15(3):264-271 The “moderate-to-high-risk” surgical patient is typically older, frail, malnourished, suffering from multiple comorbidities and presenting with unhealthy life style such as smoking, hazardous drinking and sedentarity. Poor aerobic fitness, sarcopenia and “toxic” behaviors are modifiable risk factors for major postoperative complications. The physiological challenge of lung cancer surgery has been likened to...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Christoph Ellenberger Raoul Schorer Benoit Bedat Andres Hagerman Frederic Triponez Wolfram Karenovics Marc Licker Source Type: research

The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery
Marc Licker, Andres Hagerman, Alexandre Jeleff, Raoul Schorer, Christoph EllenbergerSaudi Journal of Anaesthesia 2021 15(3):250-263 More than 70 years after its original report, the hypoxic pulmonary vasoconstriction (HPV) response continues to spark scientific interest on its mechanisms and clinical implications, particularly for anesthesiologists involved in thoracic surgery. Selective airway intubation and one-lung ventilation (OLV) facilitates the surgical intervention on a collapsed lung while the HPV redirects blood flow from the “upper” non-ventilated hypoxic lung to the “depe...
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Marc Licker Andres Hagerman Alexandre Jeleff Raoul Schorer Christoph Ellenberger Source Type: research

Special issue on & #8220;Thoracic anesthesia & #8221;
Abdelazeem EldawlatlySaudi Journal of Anaesthesia 2021 15(3):249-249 (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - June 19, 2021 Category: Anesthesiology Authors: Abdelazeem Eldawlatly Source Type: research

Difficult central venous catheter insertion via the right subclavian vein
Yasuhiro Morimoto, Manabu YoshimuraSaudi Journal of Anaesthesia 2021 15(2):245-247 (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - April 1, 2021 Category: Anesthesiology Authors: Yasuhiro Morimoto Manabu Yoshimura Source Type: research

Lidocaine swallow analgesia for severe painful prolonged esophageal disorders
Olumuyiwa A Bamgbade, Zaina S Aloul, Demilade A Omoniyi, Sikiru A Adebayo, Vivian O Magboh, Suhasini P RodriguesSaudi Journal of Anaesthesia 2021 15(2):244-245 (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - April 1, 2021 Category: Anesthesiology Authors: Olumuyiwa A Bamgbade Zaina S Aloul Demilade A Omoniyi Sikiru A Adebayo Vivian O Magboh Suhasini P Rodrigues Source Type: research

Eccentric aortic regurgitation jet: Is it benign or needs attention ?
Nishant Ram Arora, Madan Mohan MaddaliSaudi Journal of Anaesthesia 2021 15(2):242-244 (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - April 1, 2021 Category: Anesthesiology Authors: Nishant Ram Arora Madan Mohan Maddali Source Type: research

Epicardial echocardiography for left ventricular epicardial lead placement during cardiac resynchronization
Don Jose Palamattam, Santhosh Vilvanathan, Nagarjuna Panidapu, Shrinivas V GadhinglajkarSaudi Journal of Anaesthesia 2021 15(2):241-242 (Source: Saudi Journal of Anaesthesia)
Source: Saudi Journal of Anaesthesia - April 1, 2021 Category: Anesthesiology Authors: Don Jose Palamattam Santhosh Vilvanathan Nagarjuna Panidapu Shrinivas V Gadhinglajkar Source Type: research