Abstract
There has been a shift toward minimally invasive thoracic procedures employing thoracoscopy as opposed to open thoracotomy, which has been associated with less morbidity and decreased hospital length of stay. The anesthesiologist has a vital role in perioperative management of patients undergoing thoracic procedures, as implementation of lung protective strategies, goal-directed fluid management, and thoracic epidural analgesia have all been shown to improve patient outcome. It is important for the anesthesiologist to recognize patients with particularly dangerous pathology who can become acutely unstable with the induction of anesthesia, including those with anterior mediastinal masses and hemodynamically significant pericardial effusions. Given the vital structures located within the chest, every thoracic procedure has the potential for life threatening harm from injury to surrounding structures. This review contains 3 figures, 5 tables, and 15 references. Key Words: cardiac tamponade, goal-directed fluid therapy, innominate artery compression, mediastinal mass, mediastinoscopy, pectus excavatum, single lung ventilation, SVC syndrome, thoracic epidural analgesia
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