Open lung biopsy with local anesthesia

Background: Open lung biopsy may be required in the patients with parenchymal lung disease who do not have a clearly defined diagnosis. There is no doubt thoracotomy with general anesthesia is preferable to local anesthesia; but it is associated with high risks in the severally ill patients. The aim of this study is to review our experience and compare the efficacy and complications of using local anesthesia versus general anesthesia for open lung biopsies in high risk patients. Methods: From January 2002 to September 2004, Twenty five patients (18 males, 7 females) underwent open lung biopsy using minithoracotomy in the Baqiyatallah hospital in Tehran. 14 (56%) of them had open lung biopsy using general anesthesia (GA) and 11 (44%) selected for this procedure with local anesthesia (LA), all of LA group were excluded from GA because of their poor condition. we reviewed effectiveness of LA for minithoracotomy and also compared the safety, accuracy and various complications of this procedure between the two methods of anesthesia. Results: The mean age in the first (GA) group was 42.5 (+/- 14.7) years and in the second (LA) group was 49.6 (+/- 12.2) years (NS). The average length of hospital stay, postoperative air leak, and the diagnostic accuracy was not significantly different between the two groups. There was one operative-related mortality in the second group (NS). Conclusion: In selected patients with diffuse lung disease or peripheral lesions Local anesthesia is an acceptable substitute to general anesthesia for minithoracotomy to obtain adequate lung tissue for accurate diagnosis.