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Edited by
Dharti Patel, Mount Sinai West and Morningside Hospitals, New York,Sang J. Kim, Hospital for Special Surgery, New York,Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York,Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
General anesthesia is a complex drug-induced state of consciousness, amnesia, analgesia and immobility. General anesthesia causes changes to physiological, cardiovascular, and respiratory status. This chapter discusses the techniques for induction of general anesthesia, airway assessment/management, and the ASA difficult airway algorithm.
For many thoracic operations lung separation to enable collapse of the operated lung is either necessary or useful for successful surgery. Lung separation may also be required in other settings for management of pulmonary bleeding, infection or complicated lung ventilation. Lung separation requires knowledge, skill and attention to detail. New technology including videolaryngoscopy, tracheal tubes incorporating distal cameras and improvements in bronchial blocker technology have added to the anaesthetist’s armamentarium. This chapter describes the indications, techniques and complications of lung separation of relevance to generalist and specialist anaesthestists.
We report the case of a 2-year-old girl who developed catastrophic haemoptysis due to an arterio-bronchial fistula after transcatheter balloon dilatation for a narrowing aortopulmonary shunt. We embolised the fistula while haemoptysis was controlled with the left bronchial block ventilation and haemostatic balloon occlusion of the left subclavian artery. An arterio-bronchial fistula is an extremely rare complication for balloon dilatation of an aortopulmonary shunt.
This chapter, reviews thoracic surgery for a host of pathologies in children.The author discusses commonly encountered pediatric congenital lung tumors (i.e.. Congenital lobar emphysema and Congenital Cystic Adenomatous Malformations). Anesthetic implications for VATS vs open thoracotomy as well as approaches for one lung ventilation is considered. Treatment of intraoperative pulmonary issues as well as strategies for post-operative analgesia are presented.
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