P271 Because of the unknown, a failed anesthesia, second chance? an avats history

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> Studies have shown that awake or non-intubated VATS under local anesthesia(AVATS) offers significant advantages for patients,leading to improved short-term outcomes. Compared to traditional VATS with general anesthesia, AVATS boasts demonstrably shorter surgery times and hospital stays. It has also been shown in the literature that AVATS is an effective alternative for patients who cannot receive general anesthesia. <h3>Methods</h3> A 53-year-old female patient with known hypothyroidism comorbidity underwent surgery for left VATS thymectomy + left lower lobe nodule resection. The patient, who had bronchospasm and desaturation after being previously intubated and could not tolerate intubation, was operated on while awake with an epidural catheter under sedation.Dormicum and fentanyl were used for sedation. Epidural catheter was inserted at the T6 level. With oxygen support, the patient was placed in right lateral position with non entube. After giving the appropriate position, the area was cleaned and the operation was started by entering through the left 5th intercostal space after the draping. The operation was performed without complications. <h3>Results</h3> We presented a case showing that VATS operations, which cannot be performed under general anesthesia conditions, can be performed effectively with appropriate regional techniques. <h3>Conclusions</h3> According to the research, the method used in AVTS patients is; Intercostal block with light sedation(59%), laryngeal mask(43%) and thoracic epidural catheter with sedation (20%) were preferred.AVATS performed using any method is feasible and effective in patients who are incompatible with general anesthesia due to serious comorbidities and severe respiratory failure. Additionally,AVATS is associated with a noticeably lower incidence of complications after surgery.