Thoracic surgery

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• good analgesia essential
• after pneumonectomy mediastinum should be as near the centre as possible. Too much air in pneumonectomy space may compress remaining lung making ventilation difficult. May also result in an acute mediastinal shift towards the operated side which can impair venous return and cause arrhythmias. Too little air may also cause mediastinal shift with the same problems. These changes are particularly detrimental in the hypovolaemic patient
• blood loss of 200 ml/h for 4-6 h is an indication for re-operation
• most patients with good analgesia can be extubated at the end of the operation or soon after arrival in the ICU

© Charles Gomersall December 1999

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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