Patients with cancer may undergo anesthesia for many reasons, including MRI, pain management techniques or surgery. The method uses special medicine to relax patients and make them temporarily unconscious.

But what happens when the part of the body being treated – like the lungs – can’t stop moving? Thoracic anesthesia is a specialized procedure that allows one lung to continue breathing under anesthesia while the other lung is operated on.

Here are my answers to questions I often hear about this unique process and the important role it can play in a patient’s treatment plan.

Which procedures require thoracic anesthesia?

Thoracic anesthesia may be used any time a patient needs surgery in their thorax – the chest and upper portion of the abdomen.

Surgeries involving the lungs most commonly require thoracic anesthesia. These include:

• Wedge resection
• Lobectomy
• Segmentectomy
• Pneumonectomy

Patients undergoing heart surgery or surgery in the throat clavicle, ribs or chest wall may also undergo thoracic anesthesia. These areas are so close to the lungs that they may be affected by movement from the lungs during treatment.

When the lungs move, it makes it hard for the surgeon to see clearly. By keeping the lungs still, the surgeon can work more precisely. The anesthesiologist manages the patient’s breathing during surgery to make sure oxygen levels remain stable throughout the procedure. This ensures that the surgical team can operate without any risk of unintentionally interfering with the lungs.

How can a lung be isolated?

Imagine your chest as a container holding two balloons, which represent your lungs. When the surgeon needs to operate on one lung, the anesthesiologist stops airflow and may use suction to make it smaller – like letting the air out of a balloon.  When only one lung is still breathing while the other isn’t, it's called one-lung ventilation.

This technique requires a special tool called a double-lumen breathing tube, which is different from the standard endotracheal tube used in traditional anesthesia.

Think of the double-lumen as a tube with two straws at the end, each leading to one lung.

This setup allows the anesthesiologist to direct air to one lung while keeping the other isolated. Additionally, the tube often includes a small camera, which lets the anesthesiologist keep an eye on the lungs throughout the procedure.

After the surgery, the deflated lung is filled with air again to make sure it’s working properly before patients head to recovery.

Are there any side effects from thoracic anesthesia?

Because of the double-lumen breathing tube, we always inform patients that they may wake up with a sore throat. This is also a common side effect for anyone undergoing anesthesia.

Certain surgeries may require patients to lie in positions they are not used to while their care team operates on a particular area. So, patients might wake up with a crick in their neck, or their shoulder may feel sore.

Why should I seek care from an expert for thoracic anesthesia?

Anesthesiologists at MD Anderson who perform this technique are specially trained in thoracic anesthesia. They are experts in using these specific devices and equipment for this kind of surgery.

While thoracic anesthesia might seem daunting, we perform these types of procedures at MD Anderson every day. Our team will make it our top priority to ensure that you’re comfortable and safe throughout your surgery.

Request an appointment at MD Anderson online or call 1-855-401-4108.