View source for Thoracic outlet syndrome surgery

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT
| lines_access = PIV
| monitors = Standard
| considerations_preoperative = Generally young healthy females
| considerations_intraoperative = 
| considerations_postoperative = PONV
}}

'''Thoracic outlet syndrome surgery''' includes procedures such as first rib resection and scalenectomy. Symptoms include pain, tingling, or weakness in the upper extremity, with vascular involvement including venous swelling, arterial flow disruption, and deep vein thrombosis.

== Overview ==

=== Indications ===

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|May have numbness/tingling in affected upper extremity
|-
|Cardiovascular
|May have vascular involvement (venous swelling, DVT, arterial compression)
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===
Generally not necessary as most patients are young and healthy

=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===

* Standard GETA w/ paralysis setup

=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===

* Anxiolysis as needed

=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===

== Intraoperative management ==

=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===

=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
Standard induction for GETA, paralysis okay as no nerve monitoring needed

=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
Left or right lateral decubitus, with affected upper extremity in operative field facing up. Generally with shoulder roll.

=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

== Postoperative management ==

=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===

=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===

=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
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|
|-
|Position
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|
|-
|Surgical time
|
|
|-
|EBL
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|
|-
|Postoperative disposition
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|-
|Pain management
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|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]
[[Category:Vascular surgery]]