Anesthetic techniques were performed as described previously [18 (link)]. Patients received thoracic epidural anesthesia, or LMA Classic (Tele flex, Sweetmeat, Ireland) insertion combined with intrathoracic vagal blockade and intercostal nerve blockade. An epidural catheter was inserted at the T6/T7 or T8/T9 thoracic interspace. We administered 2% lidocaine 2 mL as a testing dose and 0.375–0.5% ropivacaine was used to attain a sensory block between the T2 and T12 dermatomes. Mask- and nasopharyngeal airway-assisted ventilation was provided with an oxygen flow of 3–5 L/min. Sedation was initiated by intravenous infusion of remifentanil and propofol. LMA was inserted after anesthetic induction, allowing spontaneous ventilation.
At the end of procedure, the collapsed lung was re-expanded with positive pressure through mask ventilation or negative-pressure suction through the chest tube. Intravenous drugs were stopped immediately and the epidural catheter was removed. Patients were transferred to the PACU, then to the ward or ICU according to the evaluation of their preoperative cardio-pulmonary function and intraoperative conditions.
At the end of procedure, the collapsed lung was re-expanded with positive pressure through mask ventilation or negative-pressure suction through the chest tube. Intravenous drugs were stopped immediately and the epidural catheter was removed. Patients were transferred to the PACU, then to the ward or ICU according to the evaluation of their preoperative cardio-pulmonary function and intraoperative conditions.
