Abstract：
We may encounter patients with chronic empyema for whom open-window thoracostomy is unavoidable. However, patients with chronic empyema are sometimes at high-risk for surgery under general anesthesia. We, herein, present our surgical experience with three chronic empyema cases who underwent open-window thoracostomy under local anesthesia. Indications for open-window thoracostomy under local anesthesia were raised PaCO2 in Case 1, old age and poor performance status in Case 2, and a history of esophageal reconstruction and vocal cordoplasty in Case 3. All patients were well during the surgery. Case 1 developed type 2 respiratory failure postoperatively and had to be put on a ventilator, but finally recuperated. The sedatives used could have exacerbated raised PaCO2 in this patient, and careful selection of anesthetic agents is mandatory. Considering pain and stress that patients suffer during open-window thoracostomy under local anesthesia, case selection is necessary. Nevertheless, we believe that open-window thoracostomy under local anesthesia is an effective option for high-risk patients.
摘要：
我们可能会遇到慢性脓胸患者，他们不可避免地要进行开窗胸造口术。然而,慢性脓胸患者有时在全身麻醉下手术的风险很高.我们,在这里，介绍我们对3例慢性脓胸患者在局部麻醉下进行开窗胸廓造口术的手术经验。病例1在局部麻醉下进行开窗胸廓造口术的适应症为PaCO2升高，病例2为老年和不良表现状态，病例3为食管重建和声带成形术史。所有患者在手术过程中都很好。病例1在术后出现2型呼吸衰竭，必须使用呼吸机，但最终恢复了。使用的镇静剂可能会加剧该患者的PaCO2升高，谨慎选择麻醉剂是强制性的。考虑到患者在局部麻醉下开窗胸廓造口术期间遭受的疼痛和压力，案例选择是必要的。然而，我们认为,对于高危患者,在局部麻醉下进行开窗胸造口术是一种有效的选择.
