Preparing, monitoring and recovering the thoracic surgery patient

When considering patients that present for thoracic surgery many aspects will be the same as for general surgery. However, unlike general surgical patients, patients for thoracic surgery will need more careful planning for requirements such as ventilation, monitoring and postoperative care of chest drains among others. This article aims to present general surgical considerations alongside those more specialised to thoracic surgery to give a complete overview of planning for the procedure involved.

The acute presentation patient will always demand the most attention from those in the practice and it will be necessary to consider whether the patient is dyspnoeic and/or has increased inspiratory/expiratory effort, reduced cardiac output and possibly pneumothorax. Responses and treatments that could be pre-empted include: oxygen therapy via tent, mask (Figure 1), nasal prongs or catheters or cage (Figure 2); intravenous access; fluid therapy; blood tests (blood gas analysis); blood pressure measurement; chest drain equipment; and stress reduction for the patient via a calming environment or sedation. Imaging of the thorax and/or abdomen may also be deemed necessary by the attending veterinary surgeon (Haskey, 2015).