bandage-green

Thoracic Sympathectomy

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, Semi-Fowlers, arms extended
Time : 30-60 min (short)
Blood Loss : Very Low (5-10 ml)
Post-op Pain : Moderate (4-6)
Maintenance Paralytic : Needed for a double-lumen tube; often omitted when a supraglottic airway or a tubeless apnoeic technique is used.
Considerations : PONV, One-Lung Ventilation / Lung Isolation

Anesthetic Approaches

1GETT, TIVA, Propofol Drip, Remifentanil Drip
2GLMA, TIVA, Propofol Drip, Remifentanil Drip
The Surgery

Positioning and access - supine with both arms abducted and the table tilted head-up so the lung apex falls away from the chain; both sides are prepped for a single sitting. Ports - one to three...

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