• Gang Wang, Changqing Gao, Qi Zhou, Tingting Chen, Yao Wang, Jiali Wang, and Jiachun Li.
• Department of Cardiovascular Surgery and PLA Institute of Cardiac Surgery, General Hospital of PLA, Beijing 100853, China. beijing-baoding@sohu.com
• J Clin Anesth. 2011 Dec 1;23(8):621-5.

Study ObjectiveTo investigate anesthetic techniques for robot-assisted endoscopic atrial septal defect (ASD) repair.DesignClinical observational study.SettingOperating room of a general military hospital.Patients56 adult, ASA physical status 1 and 2 patients undergoing elective general anesthesia.InterventionsAfter induction of general anesthesia, a left-sided, double-lumen endotracheal tube was positioned to allow single left-lung ventilation and contralateral CO(2) pneumothorax (capnothorax). With ultrasound guidance, peripheral cardiopulmonary bypass (CPB) catheters were placed.Measurements And Main ResultsAll patients tolerated single left-lung ventilation before CPB; however, hypoxia (oxygen saturation < 90%) occurred in 11 (19.6%) patients post-CPB, which required treatment with continuous positive airway pressure. Fifteen (26.8%) patients had hypotension secondary to capnothorax, which was treated with transfusion and vasopressors. Aortic cross-clamp time was 43.6 ± 11.2 minutes, and CPB time was 106.7 ± 12.4 minutes. The median intensive care unit stay was 21 hours and postoperative hospital stay was 4 to 7 days.ConclusionsThe key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax.Copyright © 2011 Elsevier Inc. All rights reserved.

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