Lung Cancer Clinical Trial
Official title:
Comparative Study Between Awake Thoracic Epidural Anaesthesia and General Anesthesia for Video Assisted Thoracoscopic Surgery
Thoracic procedures are routinely performed under general anesthesia (GA), with one lung
ventilation (OLV)by double lumen tube or (GA) in spontaneously breathing patient by TIVA or
LMA are usually combined with thoracic epidural analgesia.
However, GA whether mechanically ventilated or spontaneously breathing may have adverse
effects including peri-intubation hypoxia, trauma to the upper airway, mechanical
ventilation-induced injuries, impaired cardiac performance, neuromuscular problems in OLV and
increased risk of pneumonia, and release of proinflammatory mediators in generally.
Recently, awake thoracic epidural anesthesia (ATEA) has been used alone in thoracic
procedures The results achieved in early studies have been encouraging. ATEA may eventually
provide an alternative method to GA for thoracic procedures that would not only eliminate the
need for GA but also facilitate both surgical reconstruction and eventually patient recovery.
Recent studies suggested better clinical outcomes with ATEA, including less intraoperative
bleeding, a better control of postoperative pain, early mobilization and short hospital stay,
oral intake tolerance, reduction of surgical stress response, reduction of intraoperative
cardiac events, improvement of myocardial flow determinants and left ventricular function,
and a reduction of complications including pulmonary, thrombotic and infectious events.
n/a
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