Our Summary

This research paper is about a method of performing thoracic surgery (surgery on the chest area) while the patient is awake and not intubated (i.e., without a tube inserted into the windpipe to assist breathing). This is done using regional anesthesia, a type of pain blocking method that numbs a large area of the body. Specifically, the paper discusses thoracic epidural and spinal anesthesia, which involve injecting anesthetics around the spinal cord to block pain signals from the chest region. This study provides insights on the benefits and drawbacks of this approach in thoracic surgery.

FAQs

  1. What does the term “awake surgery” mean in the context of thoracic surgery?
  2. What is non-intubated thoracic surgery?
  3. What is the difference between thoracic epidural anaesthesia and thoracic spinal anaesthesia?

Doctor’s Tip

One helpful tip a doctor might give a patient about thoracic surgery is to follow all pre-operative instructions provided by the medical team, including fasting guidelines and medication instructions. It is also important to communicate any concerns or questions with your healthcare provider before the procedure. Additionally, it is important to follow post-operative care instructions carefully to promote healing and reduce the risk of complications. Remember to attend all follow-up appointments with your healthcare team to monitor your recovery progress.

Suitable For

Patients who are typically recommended for thoracic surgery include those with:

  • Lung cancer
  • Esophageal cancer
  • Mediastinal tumors
  • Pleural diseases (such as pleural effusion or pneumothorax)
  • Thoracic outlet syndrome
  • Chest wall deformities (such as pectus excavatum or pectus carinatum)
  • Thoracic spine disorders (such as herniated discs or spinal stenosis)
  • Tracheal or bronchial disorders (such as tracheal stenosis or bronchiectasis)
  • Diaphragmatic disorders (such as diaphragmatic hernia)

It is important for patients to undergo a thorough evaluation by a thoracic surgeon to determine if surgery is the best treatment option for their specific condition. Additionally, patients should be in good overall health and able to tolerate the surgical procedure and recovery process.

Timeline

  1. Pre-operative preparation: The patient will undergo various pre-operative tests and evaluations to assess their overall health and suitability for surgery. This may include blood tests, imaging scans, and consultations with various healthcare providers.

  2. Day of surgery: The patient will arrive at the hospital or surgical center and undergo pre-operative preparations, such as changing into a hospital gown and receiving intravenous medications. They will also meet with the surgical team to discuss the procedure and address any last-minute concerns.

  3. Anesthesia induction: The patient will be taken to the operating room where they will receive anesthesia to ensure they are comfortable and pain-free during the surgery. Depending on the type of surgery, the patient may receive general anesthesia, regional anesthesia (such as a thoracic epidural or spinal anesthesia), or a combination of both.

  4. Surgical procedure: The thoracic surgery will be performed by the surgical team, which may include a thoracic surgeon, anesthesiologist, and other healthcare providers. The surgery may involve removing a portion of the lung, repairing damaged tissues, or addressing other thoracic conditions.

  5. Post-operative recovery: After the surgery is complete, the patient will be taken to the recovery room where they will be closely monitored as they wake up from anesthesia. They may experience pain, nausea, and other side effects from the surgery and anesthesia, which will be managed by the healthcare team.

  6. Hospital stay: The patient will typically spend a few days in the hospital recovering from the surgery. During this time, they will receive pain medication, physical therapy, and other treatments to help them recover and regain strength.

  7. Follow-up care: After being discharged from the hospital, the patient will have follow-up appointments with their healthcare provider to monitor their recovery and address any ongoing issues. They may also need to undergo additional tests or treatments to ensure the success of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with thoracic surgery?
  2. How long is the recovery process following thoracic surgery?
  3. What type of anesthesia will be used during the surgery?
  4. How experienced is the surgical team in performing thoracic surgeries?
  5. Will I need to stay in the hospital after the surgery, and if so, for how long?
  6. What are the expected outcomes and success rates for this type of surgery?
  7. Are there any alternative treatment options to consider before proceeding with surgery?
  8. What post-operative care and follow-up appointments will be necessary?
  9. How can I best prepare for the surgery to ensure a successful outcome?
  10. Are there any specific lifestyle changes or restrictions I should be aware of after the surgery?

Reference

Authors: Neitzert L, Balzani E, Petitti M, Rosboch GL, Ceraolo E, Brazzi L. Journal: Br J Anaesth. 2023 Jun;130(6):e500-e501. doi: 10.1016/j.bja.2023.03.016. Epub 2023 Apr 19. PMID: 37080869