Anaesthesia for thoracoscopy in spontaneously breathing patients

The anesthetic management in 60 patients scheduled for diagnostic or therapeutic Video Assisted Thoracoscopy was described. Anaesthesia was induced with propofol or midazolam and with fentanyl or alfentanyl, and maintained with propofol continuous infusion supplemented by fentanyl or alfentanyl boluses. A carbonate solution of lidocaine 1% and bupivacaine 0.25% was used for topical anaesthesia of thoracic wall and parietal pleura. No patients required assisted ventilation. During the collapse of the lung PaCO2 increased, but decreased to values close to normal in the postoperative period. The collapse of the lung on the opeated side allowed to a good visualization of the pleura space without CO2 insufflation. We noted supraventricular tachyarrthmias only in 2 cases. No respiratory complications was observd.