Anästhesiol Intensivmed Notfallmed Schmerzther 2004; 39(10): 616-650
DOI: 10.1055/s-2004-825978
Fort- und Weiterbildung
© Georg Thieme Verlag KG Stuttgart · New York

Anästhesie in der Thoraxchirurgie

Anesthesia in Thoracic SurgeryK.  Wiedemann1 , C.  Männle1 , M.  Layer1 , F.  Herth2
  • 1Abteilung für Anästhesiologie und Intensivmedizin, Thoraxklinik am Universitätsklinikum Heidelberg
  • 2Abteilung Innere Medizin/Pneumologie, Thoraxklinik am Universitätsklinikum Heidelberg
Further Information

Publication History

Publication Date:
15 October 2004 (online)

Weiterbildungsziele In diesem Beitrag sollen folgende Weiterbildungsziele vermittelt werden: Abschätzung der postoperativen Funktionseinschränkung bei Lungenparenchymresektion und Beurteilung der funktionellen Operabilität Bedeutung von Rauchkarenz sowie pulmonaler und kardialer Funktionsverbesserung für die Verhütung postoperativer Komplikationen Auswahl und Einsatz der Instrumente zur Seitentrennung der Atemwege: Doppellumen-Tubus, Univent®-Tubus, Bronchusblocker Überwachung von Einführung und Lage der Instrumente zur Seitentrennung der Atemwege Pathophysiologie der Einlungenventilation: Wertung von Einflussfaktoren für die Oxygenierung Verfahren zur Sicherung der Oxygenierung während Einlungenventilation Beatmungsverfahren in der Tracheobronchialchirurgie Wandel von Überwachung der Vorhofdrucke zur Messung des intrathorakalen Blutvolumens zur Abschätzung der kardialen Vorlast Analgesie nach Thoraxeingriffen

Literatur

  • 1 Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection. A comprehensive analysis of incidence and possible risk factors.  Chest. 2000;  118 1263-1270
  • 2 De Decker K, Jorens P G, van Shil P. Cardiac complications after noncardiac thoracic surgery: an evidence-based current review.  Ann Thorac Surg. 2003;  75 1340-1348
  • 3 Bolliger C T, Perruchoud A P. Functional evaluation of the lung resection candidate.  Eur Respir J. 1998;  11 198-212
  • 4 Slinger P D, Johnston M R. Preoperative assessment for pulmonary resection.  J Cardiothorac Vasc Anesth. 2000;  14 202-211
  • 5 Brunelli A, Monteverde M, Al Refai M, Fiancini A. Stair climbing test predicts cardiopulmonary complications after pulmonary lobectomy in the elderly.  Ann Thorac Surg. 2004;  77 266-270
  • 6 Markos J, Mullan B P, Hillman D R, Musk A W, Antico V F, Lovegrove F T, Carter M J, Finucane K E. Preoperative assessment as predictor of mortality and morbidity after lung resection.  Am Rev Respir Dis. 1989;  139 902-910
  • 7 Schuurmans M M, Diacon A, Bolliger C T. Functional evaluation before lung resection.  Clin Chest Medicine. 2002;  23 (1) 159-172
  • 8 Cerfolio R, Allen M, Trastek V, Deschamps C, Scanlon P D, Pairolero P C. Lung resection in patients with compromised pulmonary function.  Ann Thorac Surg. 1996;  62 348-351
  • 9 Wyser C, Stulz P, Soler M, Tamm M, Müller-Brand J, Habicht J, Perruchoud A P, Bolliger C T. Prospective evaluation of an algorithm for the functional assessment of lung resection candidates.  Am J Respir Crit Care Med. 1999;  159 1450-1456
  • 10 Cohen E. Surgical treatment of end-stage emphysema: current status?.  Curr Opin Anaesthesiol. 2003;  16 53-57
  • 11 Eagle A K. et al . ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery - executive summary.  Circulation. 2002;  105 1257-1267
  • 12 Rao V, Todd T RS, Weisel R D, Komeda M, Cohen G, Ikonomidis J S, Christakis G T. Results of combined pulmonary resection and cardiac operation.  Ann Thorac Surg. 1996;  62 342-347
  • 13 Walsh G L, Morice R C, Putnam J B, Nesbitt J C, McMurtrey M J, Ryan M B, Reising J M, Willis K M, Morton J D, Roth J A. Resection of lung cancer is justified in highrisk patients selected by exercise oxygen consumption.  Ann Thorac Surg. 1994;  58 704-710
  • 14 Zwissler B. Das akute Rechtsherzversagen: Ätiologie - Pathophysiologie - Diagnostik - Therapie.  Anaesthesist. 2000;  49 788-808
  • 15 Kowalewski J, Brocki M, Dryanski T, Kapron K, Barcikowski S. Right ventricular morphology and function after pulmonary resection.  Eur J Cardiothorac Surg. 1999;  15 444-448
  • 16 Reed C E, Spinale F G, Crawford F A. Effect of pulmonary resection on right ventricular function.  Ann Thorac Surg. 1992;  53 578-582
  • 17 Sitbon O, Humbert M, Jagot J L, Taravella M, Fartoukh M, Parent F, Herve P, Simonneau G. Inhaled nitric oxide as a screening agent for safely identifying responders to oral calcium channel blockers in primary pulmonary hypertension.  Eur Respir J. 1998;  12 265-270
  • 18 Olschewski H, Simonneau G, Galié N. et al . Inhaled iloprost for severe pulmonary hypertension.  N Engl J Med. 2002;  347 322-329
  • 19 Leuchte H H, Schwaiblmair M, Baumgartner R A, Neurohr C F, Kolbe T, Behr J. Hemodynamic response to sildenafil, nitric oxide and iloprost in primary pulmonary hypertension.  Chest. 2004;  125 580-586
  • 20 Akrawi W, Benumof J L. A pathophysiological basis for informed preoperative smoking cessation counseling.  J Cardiothorac Vasc Anesth. 1997;  11 629-640
  • 21 Warner M A, Offord K P, Warner M E, Lennon R L, Conover M A, Jansson-Schumacher U. Role of preoperative cessation of smoking and other factors in postoperative pulmonary complications: a blinded prospective study of coronary artery bypass patients.  Mayo Clin Proc. 1989;  64 609-616
  • 22 Nakagawa M, Tanaka H, Tsukuma H, Kishi Y. Relationship between the duration of the preoperative smoke-free period and the incidence of postoperative pulmonary complications after pulmonary surgery.  Chest. 2001;  120 705-710
  • 23 Haustein K O. Pharmacotherapy of nicotine dependence.  Int J Clin Pharmac Therap. 2000;  38 273-290
  • 24 Møller A M, Villebro N, Pedersen T, Tønnesen H. Effects of preoperative smoking intervention on postoperative complications: a randomised clinical trial.  Lancet. 2002;  359 114-117
  • 25 Ho A MH, Ling E. Systemic air embolism after lung trauma.  Anesthesiology. 1999;  90 564-575
  • 26 Fitzmaurice B G, Brodsky J B. Airway rupture from double-lumen tubes.  J Cardiothorac Vasc Anesth. 1999;  13 322-329
  • 27 Brodsky J B, Macario A, Mark J BD. Tracheal diameter predicts double-lumen tube size: a method for selecting left double-lumen tubes.  Anesth Analg. 1996;  82 861-864
  • 28 Brodsky J B, Mackey S, Cannon W B. Selecting the correct size double lumen tube.  J Cardiothorac Vasc Anesth. 1997;  11 924-925
  • 29 Seymour A H. The relationship between the diameters for the adult cricoid ring and main tracheobronchial tree: a cadaver study to investigate the basis for double-lumen tube selection.  J Cardiothorac Vasc Anesth. 2003;  17 299-301
  • 30 Campos J H, Gomez M N. Pro: Right-sided double-lumen endotracheal tubes should be routinely used in thoracic surgery.  J Cardiothorac Vasc Anesth. 2002;  16 246-248
  • 31 Inoue H, Shohtsu A, Ogawa J, Kawada S, Koide S. New device for one-lung anesthesia: endotracheal tube with movable blocker.  J Thorac Cardiovasc Surg. 1982;  83 940-941
  • 32 Benumof J L, Gaughan S, Ozaki G T. Operative lung constant positive airway pressure with the Univent bronchial blocker tube.  Anesth Analg. 1992;  74 406-410
  • 33 Campos J H, Reasoner D K, Moyers J R. Comparison of a modified double-lumen endotracheal tube with a single-lumen tube with enclosed bronchial blocker.  Anesth Analg. 1996;  83 1268-1272
  • 34 Arndt G A, DeLessio S T, Kranner P W, Orzepowski W, Ceranski B, Valtysson B. One-lung ventilation when intubation is difficult: presentation of a new endobronchial blocker.  Acta Anaesthesiol Scand. 1999;  43 356-358
  • 35 Parker A B, Hoehner P J, Kloth R L, Kron I L, Baum V C. Preliminary experience with an endobronchial blocker designed for young children.  J Cardiothorac Vasc Anesth. 2003;  17 79-81
  • 36 Hammer G B. Pediatric thoracic anesthesia.  Anesth Analg. 2001;  92 1449-1464
  • 37 Benumof J L. Laryngeal mask airway and the ASA difficult airway algorithm.  Anesthesiology. 1996;  84 689-699
  • 38 Cohen E, Benumof J L. Lung separation in the patient with a difficult airway.  Curr Opin Anaesthesiol. 1999;  12 29-35
  • 39 Schottke-Hennings H, Klippe H J, Schmieding B. Die Fiberbronchoskopie als Hilfsmittel zur Plazierung und Überwachung von Doppellumentuben in der Thoraxanästhesie.  Anästh Intensivther Notfallmed. 1989;  24 327-333
  • 40 Alliaume B, Coddens J, Deloof T. Reliability of auscultation in positioning of double-lumen endobronchial tubes.  Can J Anaesth. 1992;  39 687-690
  • 41 Klein U, Karzai W, Bloos F, Wohlfarth M, Gottschall R, Fritz H, Gugel M, Seifert A. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia.  Anesthesiology. 1998;  88 346-350
  • 42 Kaplan J A, Slinger P D (eds). Thoracic Anesthesia, Third Edition. Philadelphia; Churchill Livingstone 2003
  • 43 Brodsky J B, Lemmens H JM. Left double-lumen tubes: clinical experience with 1.170 patients.  J Cardiothorac Vasc Anesth. 2003;  17 289-298
  • 44 Bahk J H, Lim Y J, Kim C S. Positioning of a double-lumen endobronchial tube without the aid of any instrument: An implication for emergency management.  J Trauma. 2000;  49 899-902
  • 45 Shankar K B, Moseley H S, Kumar A Y. Dual end-tidal CO2 monitoring and double lumen tubes.  Can J Anaesth. 1992;  39 100
  • 46 Klein U, Gugel M. Monitoring bei thoraxchirurgischen Eingriffen.  Anästhesiol Intensivmed Notfallmed Schmerzther. 1998;  33 115
  • 47 Bardoczky G I, Levarlet M, Engelman E, de Franquen P. Continuous spirometry for detection of double lumen endobronchial tube displacement.  Br J Anaesth. 1993;  70 499-502
  • 48 Schweizer A, de Perrot M, Hohn L, Spiliopoulos A, Licker M. Massive contralateral pneumonia following thoracotomy for lung resection.  J Clin Anesth. 1998;  10 678-680
  • 49 Rothen U, Sporre B, Engberg G, Wegenius G, Hedenstierna F. Airway closure, atelectasis and gas exchange during general anaesthesia.  Br J Anaesth. 1998;  81 681-686
  • 50 Triantafillou A N, Benumof J L, Lecamwasam H S. Physiology of the lateral decubitus position, the open chest and one-lung ventilation. In: Kaplan JE, Slinger PD (eds) Thoracic Anesthesia 3rd ed. Philadelphia; Churchill Livingstone 2003: 71-94
  • 51 Morrell N W, Nijran K S, Biggs T, Seed W A. Magnitude and time course of acute hypoxic pulmonary vasoconstriction in man.  Respir Physiol. 1995;  100 271-281
  • 52 Malmkvist G, Fletcher R, Nordström L, Werner O. Effects of lung surgery and one-lung ventilation on pulmonary arterial pressure, venous admixture and immediate postoperative lung function.  Br J Anaesth. 1989;  63 696-701
  • 53 Lewis J W, Serwin J P, Gabriel F S, Bastanfar M, Jacobsen G. The utility of a double lumen tube for one-lung ventilation in a variety of non-cardiac thoracic surgical procedures.  J Cardiothorac Anesth. 1992;  6 705-710
  • 54 Domino K B. Anesthetic modulation of pulmonary vascular tone. In: Yaksh TL et al. (eds) Anesthesia: Biologic Foundations. Philadelphia; Lippincott-Raven 1997: 1319-1347
  • 55 Loehr S A, Scheeren T WL, Tarnow J. Desflurane inhibits hypoxic pulmonary vasoconstriction in isolated rabbit lungs.  Anesthesiology. 1995;  83 552-556
  • 56 Schwarzkopf K, Schreiber T, Preussler N P, Gaser E, Hüter L, Bauer R, Schubert H, Karzai W. Lung perfusion, shunt fraction and oxygenation during one-lung ventilation in pigs: the effects of desflurane, isoflurane and propofol.  J Cardiothorac Vasc Anesth. 2003;  17 73-75
  • 57 Boldt J, Müller M, Uphus D, Padberg W, Hempelmann G. Cardiorespiratory changes in patients undergoing pulmonary resection using different anesthetic management techniques.  J Cardiothorac Vasc Anesth. 1996;  10 854-859
  • 58 Sykes M K, Hurtig J B, Tait A R, Chakrabarti M. Reduction of hypoxic pulmonary vasoconstriction in the dog during administration of nitrous oxide.  Br J Anaesth. 1977;  49 301-306
  • 59 v. Dossow V, Welte M, Zaune U, Martin E, Walter M, Rückert J, Kox W J, Spies C. Thoracic epidural anesthesia combined with general anesthesia: the preferred anesthetic technique for thoracic surgery.  Anesth Analg. 2001;  92 848-854
  • 60 Conacher I D. 2000 - Time to apply Occam’s razor to failure of hypoxic pulmonary vasoconstriction during one lung ventilation.  Br J Anaesth. 2000;  84 434-436
  • 61 Beck D H, Doepfmer U R, Sinemus C, Bloch A, Schenk M R, Kox W J. Effects of sevoflurane and propofol on pulmonary shunt fraction during one-lung ventilation for thoracic surgery.  Br J Anaesth. 2001;  86 38-43
  • 62 Ishibe Y, Shiokawa Y, Umeda T, Uno H, Nakamura M, Izumi T. The effect of thoracic epidural anesthesia on hypoxic pulmonary vasoconstriction in dogs: an analysis of the pressure-flow curve.  Anesth Analg. 1996;  82 1049-1055
  • 63 Hachenberg T, Holst D, Ebel C, Pfeiffer B, Thomas H, Wendt M, Hedenstierna G. Effects of thoracic epidural anaesthesia on ventilation-perfusion distribution and intrathoracic blood volume before and after induction of general anaesthesia.  Acta Anaesthesiol Scand. 1997;  41 1142-1148
  • 64 Grover R F. The fascination of the hypoxic lung.  Anesthesiology. 1985;  63 580-582
  • 65 Katz Y, Zisman E, Isserles S, Rozenberg B. Left, but not right, one-lung ventilation causes hypoxemia during endoscopic transthoracic sympathectomy.  J Cardiothorac Vasc Anesth. 1996;  10 207-209
  • 66 Ribas J, Jimenez M J, Barbera J A, Roca J, Gomar C, Canalis E, Rodriguez-Roisin R. Gas exchange and pulmonary hemodynamics during lung resection in patients at increased risk: relationship with preoperative exercise testing.  Chest. 2001;  120 852-859
  • 67 Hurford W E, Kolker A C, Strauss H W. The use of ventilation/perfusion lung scans to predict oxygenation during one-lung anesthesia.  Anesthesiology. 1987;  67 841-844
  • 68 Slinger P, Suissa S, Triolet W. Predicting arterial oxygenation during one-lung anaesthesia.  Can J Anaesth. 1992;  39 1030-1035
  • 69 Bardoczky G I, Szegedi L L, d'Hollander A A, Moures J M, de Franquen P, Yernault J C. Two-lung and one-lung ventilation in patients with chronic obstructive pulmonary disease: the effects of position and FiO2.  Anesth Analg. 2000;  90 35-41
  • 70 Watanabe S, Noguchi E, Yamada S, Hamada N, Kano T. Sequential changes of arterial oxygen tension in the supine position during one-lung ventilation.  Anesth Analg. 2000;  90 28-34
  • 71 Kerr J, Smith A C, Prys-Roberts C, Meloche R. Observation during endobronchial anaesthesia. I. Ventilation and carbon dioxide clearance.  Br J Anaesth. 1973;  45 159-167
  • 72 Hatch D. Ventilation and arterial oxygenation during thoracic surgery.  Thorax. 1966;  21 310-315
  • 73 Zollinger A, Zaugg M, Wecker W, Russi E W, Blumenthal S, Zalunardo M P, Stoehr S, Thurnheer R, Stammberger U, Spahn D R. Video-assisted thoracoscopic volume reduction surgery in patients with diffuse pulmonary emphysema: gas exchange and anesthesiological management.  Anesth Analg. 1997;  84 845-851
  • 74 Heerdt P M. Post-thoracotomy cardiovascular adaptations and complications. In: Kaplan JE, Slinger PD (eds) Thoracic Anesthesia 3rd ed. Philadelphia; Churchill Livingstone 2003: 423-435
  • 75 Zwißler B. Anästhesie bei Erkrankungen von Herz und Kreislauf. In: Rossaint R, Werner C, Zwißler B (Hrsg.) Die Anästhesiologie. Berlin; Springer 2004: 1219-1288
  • 76 Haché M, Dessault A, Belisle S, Robitaille D, Couture P, Sheridan P, Pellerin M, Babin D, Noel N, Guertin M C, Martineau R, Dupuis J. Inhaled epoprostenol (prostacyclin) and pulmonary hypertension before cardiac surgery.  J Thorac Cardiovasc Surg. 2003;  125 642-649
  • 77 Della Rocca G, Coccia C, Pompei L, Ruberto F, Venuta F, De Giacomo T, Pietropaoli P. Hemodynamic and oxygenation changes of combined therapy with inhaled nitric oxide and inhaled aerosolized prostacyclin.  J Cardiothorac Vasc Anesth. 2001;  15 244-227
  • 78 Cardinale D, Martinoni A, Cipolla C M, Civelli M, Lamantia G, Fiorentini C, Mezzetti M. Atrial fibrillation after operation for lung cancer: clinical and prognostic significance.  Ann Thorac Surg. 1999;  68 1827-1831
  • 79 Scherer R W, Vigfusson G, Hultsch E, Van Aken H, Lawin P. Prostaglandin F2α improves oxygen tension and reduces venous admixture during one-lung ventilation in anesthetized paralyzed dogs.  Anesthesiology. 1985;  62 23-28
  • 80 Chen T L, Ueng T H, Huang C H, Chen C L, Huang F Y, Lin C J. Improvement of arterial oxygenation by selective infusion of prostaglandin E1, to ventilated lung during one-lung ventilation.  Acta Anaesthesiol Scand. 1996;  40 7-13
  • 81 Chen T L, Lee T Y, Wang M J, Lee J M, Lee Y C, Chu S H. Endothelin-1 concentrations and optimisation of arterial oxygenation and venous admixture by selective pulmonary artery infusion of prostaglandin E1 during thoracotomy.  Anaesthesia. 1996;  51 422-426
  • 82 Hedenstierna G, Reber A. Manipulating pulmonary blood flow during one-lung anaesthesia.  Acta Anaesthesiol Scand. 1996;  40 2-4
  • 83 Moutafis M, Liu N, Dalibon N, Kuhlman G, Fischler M. The effects of intravenous almitrine on oxygenation and hemodynamics during one-lung ventilation.  Anesth Analg. 2002;  94 830-834
  • 84 Dalibon N, Moutafis M, Lin N, Law-Koune J D, Monsel S, Fischler M. Treatment of hypoxemia during one-lung ventilation using intravenous almitrine.  Anesth Analg. 2004;  98 590-594
  • 85 B’chir A, Mebazaa A, Losser M R, Romieu M, Payen D. Intravenous almitrine bismesylate reversibly induces lactic acidosis and hepatic dysfunction in patients with acute lung injury.  Anesthesiology. 1998;  89 823-830
  • 86 Capan L M, Turndorf H, Patel C, Ramanathan S, Acinapura A, Chalon J. Optimization of arterial oxygenation during one-lung anesthesia.  Anesth Analg. 1980;  59 847-851
  • 87 Hughes S A, Benumof J L. Operative lung continuous airway pressure to minimize FiO2 during one lung ventilation.  Anesth Analg. 1990;  71 92-95
  • 88 Barker S J, Clarke C, Trivedi N, Hyatt J, Fynes M, Rössler P. Anesthesia for thorcoscopic laser ablation of bullous emphysema.  Anesthesiology. 1993;  78 44-50
  • 89 Knüttgen D, Zeidler D, Vorweg M, Doehn M. Einseitige High Frequency Jet Ventilation als Ergänzung der Einlungenbeatmung bei thoraxchirurgischen Eingriffen.  Anaesthesist. 2001;  50 585-589
  • 90 Brock H, Rieger R, Gabriel C, Pölz W, Moosbauer W, Necek S. Haemodynamic changes during thoracoscopic surgery. The effects of one-lung ventilation compared with carbon dioxide insufflation.  Anaesthesia. 2000;  55 10-16
  • 91 Joyce C J, Barker A B, Kennedy R R. Gas uptake from an unventilated area of lung: computer model of absorption atelectasis.  J Appl Physiol. 1993;  74 1107-1116
  • 92 Pfitzner J, Peacock M J, Daniels B W. Ambient pressure oxygen reservoir apparatus for use during one-lung anaesthesia.  Anaesthesia. 1999;  54 454-458
  • 93 Weiler N, Eberle B, Heinrichs W. Adaptive lung ventilation (ALV) during anesthesia for pulmonary surgery: automatic response to transitions to and from one-lung ventilation.  J Clin Monit. 1998;  14 245-252
  • 94 Slinger P, Hickey D R. The interaction between PEEP and auto-PEEP during one-lung ventilation.  J Cardiothorac Vasc Anesth. 1999;  12 142-144
  • 95 Stühmeier K D, Mainzer B, Lipfert P, Torsello G. Ipsilateraler Pneumothorax bei Ein-Lungen-Beatmung.  Anaesthesist. 1997;  46 43-45
  • 96 Tugrul M, Camci H, Karadeniz H, Sentürk M, Pembeci K, Akpir K. Comparison of volume controlled with pressure controlled ventilation during one-lung anaesthesia.  Br J Anaesth. 1997;  79 306-310
  • 97 Sticher J, Müller M, Scholz S, Schindler E, Hempelmann G. Controlled hypercapnia during one-lung ventilation in patients undergoing pulmonary resection.  Acta anaesthesiol scand. 2001;  45 842-847
  • 98 Slinger P D, Kruger M, McRae K, Winton T. Relation of the static compliance curve and positive end-exspiratory pressure to oxygenation during one-lung ventilation.  Anesthesiology. 2001;  95 1096-1102
  • 99 Inomata S, Nishikawa T, Saito S, Kihara S. ”Best” PEEP during one-lung ventilation.  Br J Anaesth. 1997;  78 754-756
  • 100 Biro P, Wiedemann K. Jetventilation und Anästhesie für diagnostische und therapeutische Eingriffe an den Atemwegen.  Anaesthesist. 1999;  48 669-685
  • 101 Jones M J, Mottram S D, Lin E S, Smith G. Measurement of entrainment ratio during high frequency jet ventilation.  Br J Anaesth. 1990;  65 197-203
  • 102 Männle C, Herth F J, Becker H D, Wiedemann K. Controlling of high frequency jet ventilation (HFJV) by measurement of the transcutaneous carbon dioxide tension (tcpCO2) during rigid bronchoscopy.  Chest. 2003;  124 125
  • 103 Adelsmayr E, Keller C, Erd G, Brimacombe J. The laryngeal mask and high frequency jet ventilation for resection of high tracheal stenosis.  Anesth Analg. 1998;  86 907-908
  • 104 Della Rocca G, Costa M G. Preload indexes in thoracic anesthesia.  Curr Opin Anaesth. 2003;  16 69-73
  • 105 Morewood G H, Gallagher M E, Gaughan J P, Conlay L A. Current practice patterns for adult perioperative transesophageal echocardiography in the United States.  Anesthesiology. 2001;  95 1507-1512
  • 106 Brock H, Gabriel C, Bibl D, Necek S. Monitoring intravascular volumes for postoperative volume therapy.  Eur J Anaesthesiol. 2002;  19 288-294
  • 107 Buhre W, Buhre K, Kazmaier S, Sonntag H, Weyland A. Assessment of cardiac preload by indicator dilution and transesophageal echocardiography.  Eur J Anaesthesiol. 2001;  18 662-667
  • 108 Della Rocca G, Costa G M, Coccia C, Pompei L, Di Marco P, Pietropaoli P. Preload index: pulmonary artery occlusion pressure versus intrathoracic blood volume monitoring during lung transplantation.  Anesth Analg. 2002;  95 835-843
  • 109 Wiedemann K, Klein U. Besonderheiten der Atemwegssicherung in der Thoraxchirurgie. In: Krier C, Georgi R (Hrsg.) Airway Management. Stuttgart; Thieme 2001: 348-361
  • 110 Slinger P. Post-pneumonectomy pulmonary edema: is anesthesia to blame?.  Curr Opin Anesth. 1999;  12 49-54
  • 111 Moeller A, Pedersen T, Svendsen P E, Engquist A. Perioperative risk factors in elective pneumonectomy.  Eur J Anaesthesiol. 2002;  19 57-62
  • 112 Slinger P D. Acute lung injury after pulmonary resection: more pieces of the puzzle.  Anesth Analg. 2003;  97 1555-1557
  • 113 Licker M, de Perrot M, Spiliopoulos A, Robert J, Diaper J, Chevalley C, Tschopp J M. Risk factors for acute lung injury after thoracic surgery for lung cancer.  Anesth Analg. 2003;  97 1558-1565
  • 114 West J B. Pulmonary capillary stress failure.  J Appl Physiol. 2000;  89 2483-2489
  • 115 Lases E C, Duurkens V A, Gerritsen W B, Haas F JLM. Oxidative stress after lung resection therapy.  Chest. 2000;  177 999-1003
  • 116 Jordan S, Mitchell J A, Quinlan G L, Goldstraw P, Evans T W. The pathogenesis of lung injury following pulmonary resection.  Eur Respir J. 2000;  15 790-799
  • 117 Williams E A, Evans T W, Goldstraw P. Acute lung injury following lung resection: is one lung anaesthesia to blame?.  Thorax. 1996;  51 114-116
  • 118 Waller D A, Keavey P, Woodfine L, Dark J H. Pulmonary endothelial permeabilitiy changes after major resections.  Ann Thorac Surg. 1996;  61 1435-1440
  • 119 Deslauriers J, Aucoin A, Gregoire J. Postpneumonectomy pulmonary edema.  Chest Surg Clin North Am. 1998;  8 (3) 611-631
  • 120 Mathisen D J, Kuo E Y, Hahn C, Moncure A C, Wain J C, Grillo H C, Hurford W E, Wright C D. Inhaled nitric oxide for adult respiratory distress syndrome after pulmonary resection.  Ann Thorac Surg. 1998;  66 1894-1902
  • 121 Nomori H, Naruke H H, Suemasu K. What ist the advantage of a thoracoscopic lobectomy over a limited thoracotomy procedure for lung cancer surgery?.  Ann Thorac Surg. 2001;  72 879-884
  • 122 Conacher I D, Slinger P D. Pain Management. In: Kaplan JE, Slinger PD (eds) Thoracic Anesthesia 3rd ed. Philadelphia; Churchill Livingstone 2003: 436-462
  • 123 Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, Sage D, Futter M, Saville G, Clark T, McMahon S. Reduction of postoperative mortalitiy and morbidity with epidural or spinal anaesthesia: results from overview of randomized trials.  BMJ. 2000;  321 1493-1497
  • 124 Taeger K. Stellungnahmen (Pro und Kontra: Thorakaler Epiduralkatheter zur postoperativen Schmerztherapie).  Anästhesiol Intensivmed Notfallmed Schmerzther. 2004;  39 179-182
  • 125 Brodner G, Mertes N, Buerkle H, Marcus M AE, van Aken H. Acute pain management: analysis, implications and consequences after prospective experience with 6349 surgical patients.  Eur J Anaesth. 2000;  17 566-575
  • 126 Park W Y, Thompson J S, Lee K K. Effects of epidural anesthesia and analgesia on perioperative outcome.  Ann Surg. 2001;  234 560-571
  • 127 Rigg J RA, Jamrozik K, Myles P S, Gilbert B S, Peyton P J, Parsons R W, Collins K S. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial.  Lancet. 2002;  359 1276-1282
  • 128 Peyton P J, Myles P S, Gilbert B S, Rigg J A, Jamrozik K, Parsons R. Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients.  Anesth Analg. 2003;  96 548-554
  • 129 de Leon Casasola O A. When it comes to outcome, we need to define what a perioperative epidural technique is.  Anesth Analg. 2003;  96 315-318
  • 130 Taeger K. Kontra: Thorakaler Epiduralkatheter zur postoperativen Schmerztherapie.  Anästhesiol Intensivmed Notfallmed Schmerzther. 2003;  38 802-804
  • 131 Schewe J C, Hering R. Pro: Thorakaler Epiduralkatheter zur postoperativen Schmerztherapie.  Anästhesiol Intensivmed Notfallmed Schmerzther. 2003;  38 798-801
  • 132 Scherer R, Giebler R. Thorakale Epiduralanästhesie.  Anästhesiol Intensivmed Notfallmed Schmerzther. 2003;  38 168-190
  • 133 Horlocker T T, Caplan R A. Should regional blockade be performed on anesthetized patients?.  ASA Newsletter. 1001;  65 5
  • 134 Meißner A, Rolf N, van Aken H. Thoracic epidural anesthesia and the patient with heart disease: benefits, risks and controversies.  Anesth Analg. 1997;  85 517-528
  • 135 Riedel B JCJ. Regional anesthesia for major cardiac and noncardiac surgery: more than just a strategy for effective analgesia?.  J Cardiothorac Vasc Anesth. 2001;  15 279-281
  • 136 Groban L, Dolinski S Y, Zvara D A, Oaks T. Thoracic epidural analgesia: its role in postthoracotomy atrial arrhythmias.  J Cardiothorac Vasc Anesth. 2000;  14 662-665
  • 137 Groeben H, Schäfer B, Pavlakovic G, Silvanus M T, Peters J. Lung function under high thoracic segmental epidural anesthesia with ropivacaine or bupivacaine in patients with severe obstructive pulmonary disease undergoing breast surgery.  Anesthesiology. 2002;  96 536-541
  • 138 Gruber E M, Tschernko E M, Kritzinger M, Deviatko E, Wisser W, Zurakowski D, Haider W. The effects of thoracic epidural analgesia with bupivacaine 0.25 % on ventilatory mechanics in patients with severe chronic pulmonary disease.  Anesth Analg. 2001;  92 1015-1019
  • 139 Møinicke S, Kehlet H, Dahl J B. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief.  Anesthesiology. 2002;  96 725-741
  • 140 Obata H, Saito S, Fujita N, Fuse Y, Ishizaki K, Goto F. Epidural block with mepivacaine before surgery reduces longterm post-thoracotomy pain.  Can J Anaesth. 1999;  46 1127-1132

1 O2-Konzentration im Jet-Gas

Prof. Dr. med. Klaus Wiedemann

Thoraxklinik Heidelberg gGmbH · Abt. für Anästhesiologie und Intensivmedizin

Amalienstr. 5 · 69126 Heidelberg

Email: klaus.wiedemann@thoraxklinik-heidelberg.de