Abstract
The Nuss procedure is a new, minimally invasive technique for the correction of pectus excavatum using a thoracoscope. We describe the anesthetic management of nine patients (3-14yrs old) who had the Nuss procedure. We used two-lung ventilation in eight out of nine cases instead of one-lung ventilation, which most anesthesiologists have chosen in previous reports. However, no respiratory complications, such as hypoxemia and hypercapnia, occurred during the operation with a good visual field by surgeons. However, arrhythmia, premature atrial contractions, premature ventricular contractions, and ventricular tachycardia and bradycardia were observed, especially when a pectus bar was advanced in the mediastinum. In all cases, postoperative complications, such as atelectasis, pneumothorax and subcutaneous emphysema, occurred. Six out of nine cases except for the case with epidural analgesia complained of pain ranging from mild to severe. Although the Nuss procedure is "minimally invasive", anesthesiologists should be aware that many complications may occur and postoperative pain management is mandatory.
