Awake Video-assisted Thoracic Surgery with Thoracic Epidural Anesthesia in a Patient with Chronic Obstructive Pulmonary Disease

Year 2024, Volume: 10 Issue: 3, 287 - 293, 31.10.2024

Zeynep Ceren Yahşi , Kairatbek Miizamov , İsmail Duymaz , Celal Kaya , Onur Derdiyok , Sevgi Kesici , Sibel Oba

Abstract

Video-assisted thoracic surgery is the gold standard for minimally invasive surgery and can eliminate the need for general anesthesia in high-risk patients. In patients with significant respiratory dysfunction, such as chronic obstructive pulmonary disease, the choice of anesthesia technique is critical for surgical outcomes. This case report examines the application of thoracic epidural anesthesia during awake video-assisted thoracic surgery in a patient with advanced-stage chronic obstructive pulmonary disease. Thoracic epidural anesthesia offers significant advantages, including effective pain management, reduced opioid consumption, and improved postoperative respiratory function. Furthermore, it contributes to the reduction of postoperative complications and acceleration of recovery by minimizing the risks associated with tracheal intubation and mechanical ventilation. This case demonstrates that thoracic epidural anesthesia is safe and effective for video-assisted thoracic surgery with stable hemodynamic and respiratory parameters.

Keywords

Awake Surgery, Thoracic Epidural Anesthesia, Video-Assisted Thoracic Surgery, Chronic Obstructive Pulmonary Disease.

Kronik Obstrüktif Akciğer Hastalığı Olan Bir Hastada Torasik Epidural Anestezi ile Uyanık Video Yardımlı Torasik Cerrahi

Abstract

Video yardımlı torasik cerrahi, minimal invaziv cerrahinin altın standardı olup, risk grubundaki hastalarda genel anestezi ihtiyacını ortadan kaldırma potansiyeline sahiptir. Kronik obstrüktif akciğer hastalığı gibi ciddi solunum fonksiyon bozukluğu olan hastalarda, anestezi yöntemi seçimi cerrahi sonuçlar için kritik öneme sahiptir. Bu vaka raporunda, ileri evre kronik obstrüktif akciğer hastalığı olan hastada uyanık video yardımlı torasik cerrahi sırasında torasik epidural anestezinin uygulanması incelenmiştir. Torakal epidural anestezi, etkili ağrı yönetimi, opioid kullanımının azaltılması ve postoperatif solunum fonksiyonlarının iyileştirilmesi gibi önemli avantajlar sunmaktadır. Ayrıca, trakeal entübasyon ve mekanik ventilasyona bağlı riskleri en aza indirerek postoperatif komplikasyonların azalmasına ve iyileşme sürecinin hızlanmasına katkı sağlamaktadır. Bu vaka, stabil hemodinamik ve solunum parametreleri ile birlikte torakal epidural anestezinin video yardımlı torasik cerrahide güvenli ve etkili olduğunu göstermektedir.

Keywords

Uyanık Cerrahi, Torasik Epidural Anestezi, Video Yardımlı Torasik Cerrahi, Kronik Obstrüktif Akciğer Hastalığı.

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