Anaes · Thoracic anaesthesia
VATS lobectomy anaesthesia and postoperative analgesia
Also known as VATS analgesia · Thoracic epidural · Paravertebral block · Lobectomy anaesthesia · ERAS thoracic
Anaesthesia for VATS lobectomy with lung isolation, protective OLV, and multimodal analgesia comparing thoracic epidural, paravertebral, ESP and systemic opioid-sparing strategies.
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10 MCQs with explanations
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Meet the patient
A 68-year-old ex-smoker with COPD, FEV1 around 60 percent predicted and no resting hypercapnia, is listed for a right lower lobectomy by VATS. He is on apixaban for atrial fibrillation, stopped yesterday. Two questions decide whether he goes home breathing freely or returns with pneumonia: how do you keep him oxygenating on one lung, and how do you keep him coughing afterwards?[3]
Hold those two questions and the whole topic slots into place — isolation and protective ventilation answer the first, regional plus multimodal analgesia answer the second.[3]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Anaesthesia fellowship atlas.
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- [1]Wu Z et al. Paravertebral vs Epidural Anesthesia for Video-assisted Thoracoscopic Surgery: A Randomized Trial Ann Thorac Surg, 2023.PMID 37573993
- [2]Yeap YL et al. Randomized Prospective Study Evaluating Single-Injection Paravertebral Block, Paravertebral Catheter, and Thoracic Epidural Catheter for Postoperative Regional Analgesia After Video-Assisted Thoracoscopic Surgery J Cardiothorac Vasc Anesth, 2020.PMID 32144059
- [3]Brassard CL et al. Step-by-step clinical management of one-lung ventilation: continuing professional development Can J Anaesth, 2014.PMID 25389025