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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

Lobectomy
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.
"three legged stool" to estimate postoperative lung function - most commonly: PFT's to estimate ppoDLCO & ppoFEV1, functional status / echo

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
In development
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

References