Awake thoracic surgery procedures have now been successfully performed in early series
with satisfactory results.
Potential advantages include short hospitalization and immediate resumption of daily life activities,
even in functionally compromised patients, as well as a minor impact on postoperative immune function
and hormone stress response.
So far, awake anesthesia has been mainly employed to perform simple surgical procedures. In this
setting, we have preferred thoracic epidural anesthesia but local anesthesia and paravertebral blocks are
also promising alternatives, which have been successfully used.
Future perspectives might include ambulatory awake thoracic surgery programs as well as
standardization of more complex awake surgical procedures such as thymectomy and anatomical lung
resections.
The rapidly growing clinical experience and the accomplishment of properly controlled studies will
provide more answers regarding the advantages and limits of this intriguing novel surgical approach
when dealing with the various proposed indications.
Keywords: Awake thoracic surgery, VATS, epidural anesthesia, local anesthesia, complication.
