Chen Zhigang, Ali Jason M, Xu Huan, Jiang Lei, Aresu Giuseppe
Department of Thoracic Surgery and Anaesthesia, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
Thoracic Surgery, Royal Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK.
J Thorac Dis. 2018 Dec;10(12):6987-6992. doi: 10.21037/jtd.2018.11.90.
Subxiphoid video-assisted thoracoscopic surgery (VATS) is a surgical approach in minimally invasive thoracic surgery that aims to aid enhanced recovery by reducing postoperative pain by avoiding instrumentation of the intercostal spaces. Access through a subxiphoid port presents challenges for both the surgeon and anaesthetist. Particularly for left sided procedures, the heart can be compressed resulting in arrhythmia and haemodynamic compromise. The anaesthetic team play an important role in ensuring the success of subxiphoid VATS procedures. The key is continuous and comprehensive monitoring for circulatory disturbance and arrhythmia intraoperatively. Should arrhythmia develop it is important that it is managed rapidly and effectively in such a manner to minimize haemodynamic disturbance. In this article, important considerations for anaesthesia in subxiphoid VATS procedures is presented and solutions presented.
剑突下电视辅助胸腔镜手术（VATS）是微创胸外科手术中的一种手术方法，旨在通过避免肋间空间的器械操作来减轻术后疼痛，从而促进更快恢复。通过剑突下切口进行手术对外科医生和麻醉师来说都具有挑战性。特别是对于左侧手术，心脏可能会受到压迫，导致心律失常和血流动力学不稳定。麻醉团队在确保剑突下VATS手术成功方面发挥着重要作用。关键是术中持续全面监测循环系统紊乱和心律失常。一旦发生心律失常，重要的是要迅速有效地进行处理，以尽量减少血流动力学紊乱。本文介绍了剑突下VATS手术麻醉的重要注意事项并提出了解决方案。
