TOTAL INTRAVENOUS ANESTHESIA WITH SINGLE-LUMEN ENDOTRACHEAL INTUBATION FOR THORACOSCOPIC SYMPATHECTOMY

The aim of this paper was to discuss the stress applied to the circula tory and respiratory systems by the combination of general anaesthesia and thoracoscopic sympathectomy and to show the benefits of an intrav enous anaesthetic technique together with a single-lumen endotracheal tube as a safe method of anaesthesia for this procedure. In a retrospe ctive study, 125 cases of thoracoscopic sympathectomy were reviewed. T he anaesthesia was a totally intravenous technique with propofol, alfe ntanil, and atracurium and a gas mixture of 40% oxygen in air. The deg ree of hypoxaemia during inflation of carbon dioxide into the thorax w as assessed. The results showed that hypoxaemia caused no problems in any of the patients. Three patients with severe angina pectoris were a lso studied using the same anaesthetic technique and they showed marke d haemodynamic instability throughout the procedure requiring inotropi c support. Haemodynamic values obtained through a Swan-Ganz catheter i n one patient showed marked changes during the procedure, but values r eturned to normal after the operation. Although these patients were ha emodynamically unstable there was no problem with hypoxaemia.