Survey of thoracic anesthetic practice in Italy

Abstract

Objective: The object of this study was to conduct and analyze the output of a survey involving a cohort of all Italian hospitals performing thoracic surgery to gather data on anesthetic management, one-lung ventilation (OLV) management, and post-thoracotomy pain relief in thoracic anesthesia.

Design: Survey.

Setting: Italy.

Participants: An invitation to participate in the survey was e-mailed to all the members of the Italian Society of Anesthesia and Intensive Care Medicine.

Intervention: None.

Measurements and main results: A total of 62 responses were received from 47 centers. The key findings were: Double-lumen tube is still the first choice lung separation technique in current use; pressure-controlled ventilation and volume-controlled ventilation modes are homogenously distributed across the sample and, a tidal volumes (VT) of 4-6 mL/kg during OLV was preferred to all others; moderate or restrictive fluid management were the most used strategies of fluid administration in thoracic anesthesia; thoracic epidural analgesia represented the "gold standard" for post-thoracotomy pain relief in combination with intravenous analgesia.

Conclusion: The results of this survey showed that Italian anesthesiologist follow the recommended standard of care for anesthetic management during OLV.

Keywords: airway management; bronchial blockers.; double-lumen tube; fluid management; one-lung ventilation; postoperative pain relief; thoracic anesthesia.