Anesthesia for Pleural and Chest Wall Surgery

Abstract

Chest wall surgery includes cases such as resection for chest wall tumors, repair of pectus excavatum or carinatum, thoracoplasty and chest wall reconstruction. Procedures involving the pleural cavity include drainage of empyema, drainage of pleural effusions, decortication, thoracentesis, pleurodesis, and chest tube thoracostomy. These cases often present anesthetic challenges and require interdisciplinary cooperation. This chapter will discuss the physiologic considerations and alterations during chest wall and pleural cavity surgery and suggest the complete preoperative work-up. It will also delve into intraoperative considerations and monitoring as well as regional anesthetic techniques for postoperative pain control. A brief discussion of postoperative complications and special considerations for certain surgeries will be reviewed.