Department of Thoracic Surgery, Policlinico Tor Vergata University, Rome, Italy.
Semin Thorac Cardiovasc Surg. 2012 Summer;24(2):106-14. doi: 10.1053/j.semtcvs.2012.06.010.
Awake thoracic surgery is performed by regional anesthesia techniques in spontaneously breathing, fully conscious patients to avoid side-effects of general anesthesia, fasten recovery, and reduce morbidity, particularly in high-risk patients. Results of ongoing experience are promising, and this novel surgical approach has been successfully applied to several thoracoscopic procedures, including management of pleural effusion, wedge resections, lung volume reduction surgery, bullectomy, and thymectomy. In this article, the historical background, main pathophysiology features of the surgical pneumothorax, and the various regional anesthesia techniques as well as reported results are reviewed and critically discussed.
清醒开胸手术通过区域麻醉技术在自主呼吸、完全清醒的患者中进行，以避免全身麻醉的副作用，加快恢复速度，降低发病率，特别是在高危患者中。正在进行的经验结果令人鼓舞，这种新的手术方法已成功应用于几种胸腔镜手术，包括胸腔积液、楔形切除、肺减容手术、肺大疱切除术和胸腺切除术的处理。本文回顾和批判性讨论了手术性气胸的历史背景、主要病理生理学特征以及各种区域麻醉技术和报告结果。
