International anesthesiology clinics
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Int Anesthesiol Clin · Jan 1998
Anesthetic management of the cancer patient undergoing noncardiac thoracic surgery.
The scope of this article is necessarily limited, but we have addressed preoperative assessment, monitoring, and intraoperative support that might be required for surgical patients with lung, mediastinal, and esophageal cancer. The development of the subspecialty of thoracic anesthesia has been responsible for reducing mortality and improving care of all patients undergoing noncardiac thoracic surgery and has been one of the forces behind the surgeon's ability to handle bigger challenges with better results.
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Int Anesthesiol Clin · Jan 1998
Anesthetic management of the patient undergoing head and neck cancer surgery.
The head and neck cancer patient should be in the best possible medical condition before facing surgery, bearing in mind the status of the tumor and the urgency of the procedure. Careful assessment of the patient's upper airway will enable the anesthesiologist to select an appropriate course of action to secure the airway before the operation begins. In many cases, the patient can be safely intubated after the induction of general anesthesia. ⋯ If the patient has evidence of a difficult airway, a flexible fiberoptic-guided intubation may be indicated to secure the airway in the awake patient patient before general anesthesia is induced. Some patients with severe airway obstruction or large, bulky supraglottic tumors usually undergo an initial tracheostomy with local anesthesia to secure the airway. Following surgery, extubation of the patient's trachea requires careful attention and may have to be performed over a jet-ventilating stylet.