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THE achievements of transthoracic surgery in a large measure have been made possible by the concurrent advances in anesthesiology. The major problems of anesthesia with relation to the transthoracic approach to the alimentary tract are: (1) maintenance of anesthesia throughout the period of operation; (2) provision of a quiet field for the surgeon when needed; (3) maintenance of adequate oxygenation, with aspiration of the respiratory tract when indicated; (4) maintenance of circulation with proper and adequate fluids; (5) control of vagal reflexes and treatment of cardiac arrhythmias, and (6) inflation of the lungs periodically and at the conclusion of operation. Finally, the anesthetist should work closely with the surgeon in the prevention and treatment of postoperative complications as they pertain to the respiratory tract.
The choice of anesthetic agent or agents is secondary to the ability of the anesthetist to take care of the patient during operation. While it is