Anesthetic Management for Paraesophageal Hernia Repair.

Abstract

Paraesophageal hernia repairs are complex surgical cases frequently performed on patients of advanced age with multiple comorbidities, both of which create difficulties in the anesthetic management. Preoperative evaluation is challenging because of overlapping cardiopulmonary symptoms. The patient's symptoms and anatomy lead to an increased aspiration risk and the potential need for a rapid sequence induction. Depending on the surgical approach, lung isolation may be required. Communication with the surgeon is vital throughout the case, especially when placing gastric tube and bougies. Multimodal analgesia should include regional and/or neuraxial techniques, in addition to the standard intravenous and oral pain medications.

• Authors: Tatiana Kazakova, Bradley Hammond, Chad Talarek, Ashish C Sinha, Neil W Brister
• Journal: Thoracic surgery clinics (Thorac Surg Clin) Vol. 29 Issue 4 Pg. 447-455 (Nov 2019) ISSN: 1558-5069 [Electronic] United States
• PMID: 31564402 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Neuromuscular Blocking Agents

Topics

• Airway Management (methods)
• Anesthesia, General (methods)
• Fluid Therapy (methods)
• Hernia, Hiatal (surgery)
• Herniorrhaphy (methods)
• Humans
• Intubation, Gastrointestinal (methods)
• Laparoscopy
• Neuromuscular Blocking Agents (therapeutic use)
• Pain, Postoperative (therapy)
• Respiration, Artificial (methods)
• Risk Assessment