Principles and Practice of Anesthesia for Thoracic Surgery PDF
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This book, The Principles and Practice of Anesthesia for Thoracic Surgery, is designed to be a comprehensive and up-to-date reference text for all aspects of anesthesia related to noncardiac intrathoracic diagnostic and therapeutic procedures. The goal of this text is to improve the perioperative care of thoracic surgical patients. It is written for practitioners of thoracic anesthesia at all levels: Residents, Fellows, Staff Anesthesiologists, Nurse Anesthetists, Nurse Practitioners, Anesthesia Assistants, and Allied Health Professionals who are involved in managing these patients.
The spectrum of patients who require anesthesia for thoracic procedures continues to evolve. At the beginning of the last century, thoracic surgery was mainly performed for infectious diseases and their complications such as empyema, bronchiectasis, and broncho-pleural fistula. This continues to be the mainstay of thoracic anesthesia in many developing countries as described by Dr. Rebecca Jacob of Bengaluru, India, in Chap. 33. Occasionally, patients with these types of pathology present for surgery in hospitals in the developed world also, so the principles of lung separation and isolation for these cases remain fundamental building blocks of thoracic anesthesia.
By the middle of the last century, the spectrum of thoracic surgery had shifted so that the majority of patients are now patients with malignancies, particularly lung cancer. As the population changes so have the surgical procedures; from pneumonectomy and lobectomy to lungsparing procedures such as segmentectomy. And the surgical techniques have evolved from open thoracotomies to minimally invasive video-assisted thoracic surgery (VATS). This has allowed thoracic surgeons and chest physicians to expand the envelope of patients considered operable and to offer potentially curative pulmonary resections to patients with increasingly severe comorbidities. This in turn has placed a greater emphasis on the need for anesthesiologists to manage one-lung ventilation in complicated patients. VATS, and now Robotic, procedures have expanded to include esophageal, vertebral, cardiac, and other types of intrathoracic surgery. Practitioners who work in centers that do not perform lung surgery may now be required to provide anesthesia for VATS procedures.
The beginning of this century heralds the evolution of procedures for end-stage lung disease. Lung transplantation, lung volume reduction, whole-lung lavage, and pulmonary thromboendarterectomy are all examples of this new spectrum of operations for patients who require safe perioperative anesthetic care. Attendant with this expansion of surgery are new techniques and tools that the anesthesiologist must be familiar with such as transesophageal echocardiography, interventional lung assist devices, ex vivo lung perfusion, alternatives for postoperative analgesia, and lung isolation in patients with difficult airways. All of these are described in this text.
All of the clinical chapters in this text have been organized with a Clinical Case Discussion at the end. The purpose of these cases is to review the material presented in the preceding chapter and then to allow the reader to compare his/her solution to the clinical problem with that of the chapter authors. This should allow the reader to reflect on what has been discussed in the text and to get an impression of how the presented material can be applied in a clinical context.
This text begins, at the beginning, with the History of Thoracic Anesthesia in Chap. 1. This excellent and insightful introduction is written by Ian Conacher of Newcastle, England who has recently retired but has been a leading authority on thoracic anesthesia in Britain for the past several decades.
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