• Curr Opin Anaesthesiol · Apr 2021

    Review

    Does thoracic epidural anaesthesia constitute over-instrumentation in video- and robotic-assisted thoracoscopic lung parenchyma resections?

    • Torsten Loop.
    • Department of Anaesthesiology and Intensive Care Medicine, University Hospital Freiburg, Medical Faculty, Albert-Ludwigs-University Freiburg, Freiburg, Germany.
    • Curr Opin Anaesthesiol. 2021 Apr 1; 34 (2): 199-203.

    Purpose Of ReviewEffective and sustained perioperative analgesia in thoracic surgery and pulmonary resection is beneficial to patients by reducing both postoperative pulmonary complications and the incidence of chronic pain. In this review, the indication of thoracic epidural anaesthesia in video- (VATS) and robotic-assisted (RATS) thoracoscopy shall be critically objectified and presented in a differentiated way.Recent FindingsPain following VATS and RATS has a negative influence on lung function by inhibiting deep respiration, suppressing coughing and secretion and favours the development of atelectasis, pneumonia and other postoperative pulmonary complications.In addition, inadequate pain therapy after these procedures may lead to chronic pain.SummarySince clear evidence-based recommendations for optimal postoperative analgesia are still lacking in VATS and RATS, there can be no universal recommendation that fits all centres and patients. In this context, thoracic epidural analgesia is the most effective analgesia procedure for perioperative pain control in VATS and RATS-assisted surgery for patients with pulmonary risk factors.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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