TY  - BOOK
AU  - Usama Abdelkhalek Abdelwahab
AU  - Abdelrahman Mohamed Abdelrahman , 
AU  - Somaya Mohamed Elshaikh , 
AU  - Wael Ahmed Ebrahim , 
TI  - Comparative study between general anesthesia  and awake thoracic epidural anesthesia for video-assisted thoracoscopic surgery / 
PY  - 2016///
CY  - Cairo : 
PB  - Usama Abdelkhalek Abdelwahab , 
KW  - Awake thoracic epidural
KW  - GA.comined technique
KW  - OLV
N1  - Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anesthesia and Pain relief; Issued also as CD
N2  - Thoracic procedures are routinely performed under general anesthesia (GA), with  one lung ventilation (OLV)and are usually combined with thoracic epidural  analgesia. However, GA with OLV may have adverse effects including peri- intubational hypoxia, trauma to the upper airway, mechanical ventilation- induced injuries, impaired cardiac performance, neuromuscular problems, increased  risk of pneumonia, and release of proinflammatory mediators. Recently, awake  thoracic epidural anesthesia (ATEA) has been used alone in thoracic  procedures.The results achieved in early studies have been encouraging. ATEA  may eventually provide an alternative method to GA for thoracic proceduresthat  would not only eliminate the need for OLV but also facilitate both surgical  reconstruction and eventually patient recovery.Recent studies suggested better  clinical outcomes with ATEA, including less intraoperative bleeding, a better  control of postoperative pain, early mobilization, oral intake tolerance, reduction of  surgical stress response, reduction of intraoperative cardiac events, improvement of  myocardial flow determinants and left ventricular function, and a reduction of  complications including pulmonary, thrombotic and infectious events. Multiple  studies evaluated the safety of intravenous ketamine/propofol combination for   sedation and analgesia and there is evidence that this
UR  - http://172.23.153.220/th.pdf
ER  -