Total intravenous anaesthesia with single-lumen endotracheal intubation for thoracoscopic sympathectomy.

The aim of this paper was to discuss the stress applied to the circulatory and respiratory systems by the combination of general anaesthesia and thoracoscopic sympathectomy and to show the benefits of an intravenous anaesthetic technique together with a single-lumen endotracheal tube as a safe method of anaesthesia for this procedure. In a retrospective study, 125 cases of thoracoscopic sympathectomy were reviewed. The anaesthesia was a totally intravenous technique with propofol, alfentanil, and atracurium and a gas mixture of 40% oxygen in air. The degree of hypoxaemia during inflation of carbon dioxide into the thorax was assessed. The results showed that hypoxaemia caused no problems in any of the patients. Three patients with severe angina pectoris were also studied using the same anaesthetic technique and they showed marked haemodynamic instability throughout the procedure requiring inotropic support. Haemodynamic values obtained through a Swan-Ganz catheter in one patient showed marked changes during the procedure, but values returned to normal after the operation. Although these patients were haemodynamically unstable there was no problem with hypoxaemia.