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C44. PLEURAL DISEASE II -- CHEST TUBES, MANAGEMENT, PATHOPHYSIOLOGY - Thoracic Epidural Anaesthesia for Talc Powder Pleurodesis in Awake Patients. by Steppert, C; Holl, T; Sommert, C; Habich, G is a scholarly article available to read on EtoBox.

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Talc powder instillation as the most effective method for pleurodesis is performed either in local anaesthesia with conscious sedation or in general anasthesia with single lung ventilation. In local anaesthesia it can be quite painful while general anaesthesia is very ressource consuming. An optimal procedure should be cost effective and comfortable for the patient and the investigator as well. Epidural anaesthesia is used for many surgical procedures and should also be feasible for limited procedures in thoracic surgery. Since 9/2006 we have performed talc powder pleurodesis in 49 pts., 25m, 24f, aged 29 to 87, mean 58, median 68 years, during thoracoscopy in sole thoracic epidural anaesthesia with a mean dose of 6g french talc powder. Underlying disease was malignant in 45 cases, 23 due to lung cancer, 4 mesotheliomas and the remaining to metastatic cancers of other origin. Only 5 pts. Were in the favorable ASA class 1 or 2, 15 in class 3 and the remaining 27 in the high risk class 4. Thoracic epidural anaesthesia was performed with ropivacain 0.75% via catheter between 6th and 7th intervertebral space. In 4 patients epidural anaesthesia was not possible due to technical problems

Author

Steppert, C; Holl, T; Sommert, C; Habich, G

Publisher

American Thoracic Society

Published

2009

Language

EN