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Non-intubated thoracic surgery: an Asian perspective

Thoracic surgery without the use of modern general anesthesia and endotracheal intubation has a surprisingly long history in Asia. Over a half century ago, thoracic operations via thoracotomy were performed in China using acupuncture for pain suppression in awake patients. Today, East Asia continues to pioneer major thoracic operations using non-intubated techniques. A number of centers in Asia have now emerged as leaders in the development of the technique, production of clinical data, and training for the use of non-intubated thoracic surgery. Wider adoption of the non-intubated strategy across Asia is still relatively limited by the quality and evidence of the evidence thus far. However, encouraging developments in shaping and improving clinical research for non-intubated thoracic surgery in Asia suggest that this part of the world will continue to hold a central role in the future of the technique.