Anesthesia practices in thoracic surgery in Turkey: A survey study

Anesthesia Practices in Thoracic Surgery in Turkey: A Survey Study Objective: In our survey study, we aimed to investigate the methods that are applied by Anesthesiology and Reanimation physicians working in the field of thoracic surgery in Turkey Material and Method: Our survey study was conducted by obtaining electronic data using the www.Surveey.com program with the support of the Turkish Anesthesia and Reanimation Association between January and February 2021. Participants were asked to answer 35 questions about the duration of their thoracic surgery anesthesia experience, single lung ventilation and verification methods, ventilation strategies they perform, intraoperative monitoring, anaesthesia induction and maintenance methods, intraoperative fluid management, vasopressor preferences, and postoperative analgesia applications. Results: 148 Anesthesiology and Reanimation physicians have participated in our survey. 44.6% of the physicians work in state universities and 43.2% have less than 5 years of experience. While most of the participants (97.3%) preferred double-lumen endobronchial tube for one-lung ventilation, 69.6% of the respondents used auscultation method and 45.9% used fiberoptic bronchoscope in order to affirm the location of the tube. In addition to routine monitorization, while invasive blood pressure monitoring was performed at a rate of 85.8% and heat monitorization at a rate of 23.6%, 44.6% of the participants expressed that they did not apply routine central venous catheter. The rate of the participants who applied routine premedication was 45.9%. It was observed that intravenous agents were preferred for anesthesia induction and a combination of inhalation and intravenous agents were preferred for anesthesia maintenance. It was found that most of the participants used intraoperative lung protective mechanical ventilation strategies. The rate of using regional techniques for postoperative analgesia was 75%, and the rate of routine opioid use was at a rate of 89.9%. It was observed that the moderate fluid regime was applied at a rate of 57.4%, crystalloids were the first choice in fluid therapy, 57.4% of intraoperative hypotension was administered initially with controlled iv fluid, and norepinephrine was the most frequently used vasoactive agent. Blood transfusion threshold value was specified as 8 g / dl at a rate of 35.8%. 83.1% of the respondents stated that a consensus was needed in the anesthesia application of thoracic surgery in Turkey. Conclusion: Our study is the only survey study in Turkey which contains detailed data in this specific subject. The data obtained from our study shows that the anesthesia management of thoracic surgery in our country is generally compatible with the guidelines and literature followed worldwide. However, it has been concluded that trainings dealing with blood transfusion, the use of fiberoptic bronchoscope and regional techniques and intraoperative temperature monitoring should continue and a consensus is needed to be established in terms of thoracic anesthesia application. Key Words: Anesthesia, survey, thoracic surgery, Turkey