Difference between revisions of "Thoracic outlet syndrome surgery"

From WikiAnesthesia
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|Neurologic
|Neurologic
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|May have numbness/tingling in affected upper extremity
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|Cardiovascular
|Cardiovascular
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|May have vascular involvement (venous swelling, DVT, arterial compression)
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|Pulmonary
|Pulmonary
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=== 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. --> ===
=== 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. --> ===
=== 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. --> ===
=== 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. --> ===
=== 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. --> ===
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=== 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. --> ===
=== 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. --> ===
=== 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. --> ===
=== 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. --> ===

Revision as of 17:25, 4 April 2022

Thoracic outlet syndrome surgery
Anesthesia type

General

Airway

ETT

Lines and access

1 PIV

Monitors

Standard

Primary anesthetic considerations
Preoperative

Generally young healthy females

Intraoperative

N/A

Postoperative

PONV

Article quality
Editor rating
In development
User likes
0

Thoracic outlet syndrome surgeries include procedures such as First rib resection, 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

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

Generally not necessary as most patients are young and healthy

Operating room setup

  • Standard GETA w/ paralysis setup

Patient preparation and premedication

  • Anxiolysis as needed

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Standard induction for GETA, paralysis okay as no nerve monitoring needed

Positioning

Left or right lateral decubitus, with affected upper extremity in operative field facing up. Generally with shoulder roll.

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