RESUMO
Background: General anesthesia and selective ventilation has long been the traditional anesthetic approach for video-assisted thoracoscopic surgery [VATS]. However it may not always be necessary or feasible in a certain variety of patients. VATS under locoregional anesthesia and sedation has proved to be a safer and more efficacious alternative to general anesthesia, especially in cases deemed unfit for the latter
Methodology: We retrospectively reviewed medical records of patients who underwent VATS under regional anesthesia/nerve blocks with sedation in three private hospitals from April 2014 to November 2015. VATS are conducted in these hospitals by the same anesthesia team and operated by a single surgeon. Eighteen patients included in the case-series were either considered high-risk for general anesthesia or required minor to intermediate surgery. None of the patients required endotracheal intubation or conversion to thoracotomy during the procedure
Results: Eighteen patients underwent successful VATS under locoregional anesthesia with sedation at our set-up from April 2014 to November 2015. The procedures included pleural biopsies, pleurodesis, empyema drainage, biopsies for mediastinal masses, lung tumors and apical infiltrates, all performed under video-assistance. There was no perioperative mortality or unanticipated ICU admission
Conclusion: VATS under locoregional anesthesia and sedation is a valuable, efficacious and safe alternative to general anesthesia that needs to be incorporated more frequently in the modern anesthesia practice