Technological advances in video camera, high resolution monitors and optical systems have produced considerable process in endoscopic surgery.
Recently we have experienced transthoracic endoscopic sympathectomy(TES) for the treatment of Buerger's disease of both hands in a 47 years old male healthy patient.
For the TES, one lung ventilation is necessary to provide adequate surgical assess, so this patients had general anesthesia with a disposable left sided Robertshaw double lumen endobronchial tube. The patient was monitored for arterial pressure.
Heart
rate, ECG, pulse oximetry, end-tidal carbon dioxide concentration, peak inspired airway pressured and arterial blood gas analysis.
Potenial intraoperative problems were hypoxemia during one-lung anesthesia, hypotension and hypercarbia occurred by insufflation of carbon dioxide into the chest cavity.
Our patient also developed moderate hypoxemia which was corrected by application of high frequency jet ventilation with low driving pressure during right sided operation, and increased significantly arterial carbon dioxide tension about 8-12 mmHg
during
one lung ansthesia. We reviewed our experience and discussed the anesthetic technique and perioperative problems encounterd in the patient undergoing transthoracic endoscopic sympathectomy for Buerger' s disease.
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