Document Detail

Anesthesia for Thoracic Surgery: A Survey of UK Practice.
MedLine Citation:
PMID:  21868249     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The authors sought to provide a snapshot of contemporary thoracic anesthetic practice in the United Kingdom and Ireland. DESIGN: An online survey. SETTING: United Kingdom. PARTICIPANTS: An invitation to participate was e-mailed to all members of the Association of Cardiothoracic Anaesthetists. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 132 responses were received; 2 were excluded because they did not originate from the United Kingdom. Values are number (percent). ANESTHETIC TECHNIQUE: The majority of respondents (109, 85%) maintain anesthesia with a volatile anesthetic agent, with a lesser proportion (20, 15%) reporting use of a total intravenous anesthetic technique. The majority of respondents (78, 61%) favor pressure control ventilation over volume control (50, 39%); just under half (57, 45%) report the routine use of positive end-expiratory pressure (median = 5 cmH(2)O [interquartile range (IQR), 4-5]). Fifty-two (40%) respondents report ventilating to a target tidal volume (median = 6 mL/kg [IQR, 5-7]). Most (114, 89%) respondents routinely ventilate with an F(I)O(2) less than 1.0. Thoracic epidural blockade (TEB) is favored by nearly two thirds of respondents (80, 62%) compared with paravertebral block (39, 30%) and other analgesic techniques (10, 8%). Anesthesiologists favoring TEB are significantly less likely to prescribe systemic opioids (17, 21% v 39, 100% [p < 0.001]). Proponents of TEB are significantly more likely to "routinely" use vasopressor infusions both intra- and postoperatively (16, 20% v 0, 0% [p = 0.003] and 28, 35% v 4, 11% [p =0.013], respectively). Most respondents (127, 98%) report a double-lumen tube as their first choice. Many (82, 64%) report "rarely" using bronchial blockers. CONCLUSIONS: The authors hope this survey both provides interest and serves as a useful resource reflecting the current practice of thoracic anesthesia.
Ben Shelley; Alistair Macfie; John Kinsella
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-23
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  -     ISSN:  1532-8422     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Anaesthesia, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK; University of Glasgow Academic Unit of Anaesthesia, Pain and Critical Care Medicine, Glasgow, UK.
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