Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Feb 2007
EditorialManagement of the patient with a large anterior mediastinal mass: recurring myths.
This editorial review summarizes the current anesthetic management of patients with anterior mediastinal masses. ⋯ General anesthesia is not safe in patients with severe positional symptoms from an anterior mediastinal mass. With modern imaging techniques, general anesthesia is rarely needed for diagnostic procedures in these patients. Preoperative flow-volume loops are not useful in the management of these patients and the concept of cardiopulmonary bypass on 'standby' is not appropriate during induction of anesthesia.
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Curr Opin Anaesthesiol · Feb 2007
ReviewAnesthesia for thoracic surgery in morbidly obese patients.
This review considers the anesthetic management of obese patients undergoing thoracic surgery. Extremely or morbidly obese patients differ from patients of normal weight in several ways. Obese patients have altered anatomy and physiology, and usually have associated comorbid medical conditions that may complicate their operative course and increase their risks for postoperative complications. ⋯ With proper attention to their special needs, the morbidly obese patient can safely undergo thoracic surgery and one-lung ventilation.
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Curr Opin Anaesthesiol · Feb 2007
ReviewWhich device should be considered the best for lung isolation: double-lumen endotracheal tube versus bronchial blockers.
This review is a clinical comparison between double-lumen endotracheal tubes and bronchial blockers to determine which device is considered the best for lung isolation. ⋯ Double-lumen endotracheal tubes and bronchial blockers should be part of the armamentarium of every anesthesiologist involved in lung isolation techniques and every device should be tailored to specific case needs.
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To review the current anaesthetic management of patients undergoing transthoracic oesophagectomy. ⋯ Although nonsurgical treatments are being developed, at present surgery remains the mainstay of potentially curative treatment. Accurate risk stratification would greatly facilitate the assessment of strategies to reduce operative mortality. Anaesthetic research has the potential to further improve the safety of patients undergoing oesophageal surgery.