Awake thoracoscopic surgery under epidural anesthesia: is it really safe?

Thoracoscopic surgeries usually require single-lung ventilation under general anesthesia because of the need to obtain a sufficient working space. In patients with impaired pulmonary function, if the patient can undergo general anesthesia, a more selected collapse of the lung is considered to be beneficial for intraoperative oxygenation. The selective bronchial blockade of the lobe to be resected has been reported by several investigators (1-3).