Difference between revisions of "Lobectomy"
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{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = | | anesthesia_type = General | ||
| airway = | | airway = DLT, ETT with bronchial blocker | ||
| lines_access = | | lines_access = PIV, large bore IV, arterial line on dependent side in lateral position, | ||
| monitors = | | monitors = Standard, 5-lead, | ||
| considerations_preoperative = | | considerations_preoperative = Chronic respirtory disease, chronic smokers and sequelae, coexisting cardiovascular disease. | ||
| considerations_intraoperative = | </br> "three legged stool" to estimate postoperative lung function - most commonly: PFT's to estimate ppoDLCO & ppoFEV1, functional status / echo | ||
| considerations_postoperative = | | considerations_intraoperative = One lung ventilation, protective lung ventilation, managing hypoxia on one lung ventilation, thoracotomy vs minimally invasive approach | ||
| considerations_postoperative = analgesia: if VATS, regional block or PCA sufficient; if thoracotomy, epidural or PVB preferred | |||
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| | |Pulmonary | ||
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=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | === Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | ||
=== 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. --> | === Regional and neuraxial techniques === | ||
Non-opiate post-operative pain management is particularly important in this patient population due to reduced pulmonary reserve and rib pain post-operatively that may prevent effective secretion mobilization and lung expansion. | |||
* Paravertebral Block | |||
* Erector Spinae Block | |||
* Epidural - if thoracotomy<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> | |||
== Intraoperative management == | == Intraoperative management == | ||
Latest revision as of 13:30, 24 December 2025
| Anesthesia type |
General |
|---|---|
| Airway |
DLT, ETT with bronchial blocker |
| Lines and access |
PIV, large bore IV, arterial line on dependent side in lateral position, |
| Monitors |
Standard, 5-lead, |
| Primary anesthetic considerations | |
| Preoperative |
Chronic respirtory disease, chronic smokers and sequelae, coexisting cardiovascular disease.
|
| Intraoperative |
One lung ventilation, protective lung ventilation, managing hypoxia on one lung ventilation, thoracotomy vs minimally invasive approach |
| Postoperative |
analgesia: if VATS, regional block or PCA sufficient; if thoracotomy, epidural or PVB preferred |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Provide a brief summary of this surgical procedure and its indications here.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Non-opiate post-operative pain management is particularly important in this patient population due to reduced pulmonary reserve and rib pain post-operatively that may prevent effective secretion mobilization and lung expansion.
- Paravertebral Block
- Erector Spinae Block
- Epidural - if thoracotomy
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |