Recommendations from the Italian Intersociety Consensus on Perioperative Anesthesia Care in Thoracic Surgery (PACTS) Part 1: Preadmission and Preoperative Care

Overview

Journal Perioper Med (Lond)

Publisher Biomed Central

Date 2020 Dec 9

PMID 33292657

Citations 8

Authors

Federico Piccioni

Andrea Droghetti

Alessandro Bertani

Cecilia Coccia

Antonio Corcione

Angelo Guido Corsico

Roberto Crisci

Carlo Curcio

Carlo Del Naja

Paolo Feltracco

Diego Fontana

Alessandro Gonfiotti

Camillo Lopez

Domenico Massullo

Mario Nosotti

Riccardo Ragazzi

Marco Rispoli

Stefano Romagnoli

Raffaele Scala

Luigia Scudeller

Marco Taurchini

Silvia Tognella

Marzia Umari

Franco Valenza

Flavia Petrini

Affiliations

Soon will be listed here.

Abstract

Introduction: Anesthetic care in patients undergoing thoracic surgery presents specific challenges that necessitate standardized, multidisciplionary, and continuously updated guidelines for perioperative care.

Methods: A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, comprising 24 members from 19 Italian centers, was established to develop recommendations for anesthesia practice in patients undergoing thoracic surgery (specifically lung resection for cancer). The project focused on preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and PubMed and Embase literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventative Services Task Force criteria.

Results: Recommendations for preoperative care focus on risk assessment, patient preparation (prehabilitation), and the choice of procedure (open thoracotomy vs. video-assisted thoracic surgery).

Conclusions: These recommendations should help pulmonologists to improve preoperative management in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.

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