AIM: Video-assisted thoracoscopy surgery (VATS) is classically performed using general anesthesia with a double-lumen endotracheal tube to allow collapse of the operated lung. However, according to our opinion, the risks of general anesthesia with one-lung ventilation could be accepted when major thoracic operation is planned, but it should be avoided or kept at minimum when performing less invasive procedures such as video-assisted talc pleurodesis. In this paper, 2 different protocols are described in order to demonstrate the effectiveness and safety of Monitored Anesthesia Care (MAC) for performing VATS talc pleurodesis. METHODS: We studied 65 neoplastic patients ASA III-IV who underwent video-assisted pleurodesis with talc nebulization. They were randomized into 2 homogenous groups: Group 1, received midazolam (0.015-0.030 mg/kg) and sufentanil (0.15-0.20 microg/kg); Group 2, received midazolam (0.15-0.2 mg/kg) and continuous remifentanil infusion 0.5-1 microg/kg/min in the first minute, followed by 0.05 microg/kg/min. Local anesthesia with 0.2% ropivacaine was employed before the thoracoscopic trocar was inserted in both groups. Intraoperative standard monitoring required ECG, heart rate, non-invasive blood pressure, transcutaneous carbon dioxide and oxygen saturation. Consciousness status has been evaluated by Ramsey scale, while pain intensity by VAS scale. RESULTS: No statistically significant fluctuations were observed for mean arterial pressure, heart rate, SpO(2), tCO(2), VAS and Ramsey score. No postoperative complications and hospital mortality occurred. CONCLUSIONS: Both the protocols offer an efficient control of analgosedation with a minimum incidence of intraoperative and postoperative side effects. Anyway, the titration of the drug is very important.

Comparison of two protocols of conscious analgosedation in video-assisted talc pleurodesis / Gravino, Elvira; Griffo, SALVATORE G. PPE ROMANO; Gentile, Maria; Storti, M; Grossi, Natalia; Gily, B.. - In: MINERVA ANESTESIOLOGICA. - ISSN 0375-9393. - STAMPA. - 71:4(2005), pp. 157-165.

Comparison of two protocols of conscious analgosedation in video-assisted talc pleurodesis.

GRAVINO, ELVIRA;GRIFFO, SALVATORE G.PPE ROMANO;GENTILE, MARIA;GROSSI, NATALIA;
2005

Abstract

AIM: Video-assisted thoracoscopy surgery (VATS) is classically performed using general anesthesia with a double-lumen endotracheal tube to allow collapse of the operated lung. However, according to our opinion, the risks of general anesthesia with one-lung ventilation could be accepted when major thoracic operation is planned, but it should be avoided or kept at minimum when performing less invasive procedures such as video-assisted talc pleurodesis. In this paper, 2 different protocols are described in order to demonstrate the effectiveness and safety of Monitored Anesthesia Care (MAC) for performing VATS talc pleurodesis. METHODS: We studied 65 neoplastic patients ASA III-IV who underwent video-assisted pleurodesis with talc nebulization. They were randomized into 2 homogenous groups: Group 1, received midazolam (0.015-0.030 mg/kg) and sufentanil (0.15-0.20 microg/kg); Group 2, received midazolam (0.15-0.2 mg/kg) and continuous remifentanil infusion 0.5-1 microg/kg/min in the first minute, followed by 0.05 microg/kg/min. Local anesthesia with 0.2% ropivacaine was employed before the thoracoscopic trocar was inserted in both groups. Intraoperative standard monitoring required ECG, heart rate, non-invasive blood pressure, transcutaneous carbon dioxide and oxygen saturation. Consciousness status has been evaluated by Ramsey scale, while pain intensity by VAS scale. RESULTS: No statistically significant fluctuations were observed for mean arterial pressure, heart rate, SpO(2), tCO(2), VAS and Ramsey score. No postoperative complications and hospital mortality occurred. CONCLUSIONS: Both the protocols offer an efficient control of analgosedation with a minimum incidence of intraoperative and postoperative side effects. Anyway, the titration of the drug is very important.
2005
Comparison of two protocols of conscious analgosedation in video-assisted talc pleurodesis / Gravino, Elvira; Griffo, SALVATORE G. PPE ROMANO; Gentile, Maria; Storti, M; Grossi, Natalia; Gily, B.. - In: MINERVA ANESTESIOLOGICA. - ISSN 0375-9393. - STAMPA. - 71:4(2005), pp. 157-165.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/105312
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