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Anesthesia for open pulmonary resection

Randal S Blank, MD, PhD
Stephen R Collins, MD
Section Editor
Peter D Slinger, MD, FRCPC
Deputy Editor
Nancy A Nussmeier, MD, FAHA


Open pulmonary resection is most commonly performed to treat a known intrathoracic malignancy such as lung cancer or to diagnose pathology of a suspicious nodule or mass. Other indications for pulmonary resection include management of thoracic trauma, pulmonary infection, and bronchopleural fistula.

Surgical procedures for these indications include sublobar resection (segmentectomy, wedge resection), lobectomy, or removal of more than one lobe (bilobectomy, lobectomy plus segmentectomy). A pneumonectomy involves removal of the entire lung. Extrapleural pneumonectomy involves resection of the diseased lung, as well as mediastinal lymph nodes, ipsilateral pericardium, hemidiaphragm, or parietal or visceral pleura.

This topic will review anesthetic care for patients undergoing thoracotomy and open pulmonary resection, including preanesthetic consultation and preparation, intraoperative anesthetic management, and postoperative pain management. Management of patients undergoing video-assisted thoracoscopic surgery (VATS) for pulmonary resection is discussed separately. (See "Overview of minimally invasive thoracic surgery" and "Anesthesia for video-assisted thoracoscopic surgery (VATS) for pulmonary resection".)

Lung isolation techniques that are typically required for these procedures and management of one lung ventilation (OLV) are discussed separately. (See "General principles of one lung ventilation" and "Lung isolation techniques".)


History and examination — The preoperative consultation focuses on assessment of pulmonary and cardiovascular risks:

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Literature review current through: Nov 2017. | This topic last updated: Nov 09, 2017.
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