Single-Shot Thoracic Spinal Anesthesia and Serratus Anterior Plane Block for Awake Nonintubated Thoracic Surgery: A Case Report.

Awake nonintubated thoracic surgery (NITS) is a valuable approach for patients at high risk of complications from general anesthesia. We present a case of a 67-year-old patient with cholangiocarcinoma and pulmonary metastases undergoing left lingular wedge resection. Given significant hepatic impairment, single-shot thoracic spinal anesthesia (TSA) and a serratus anterior plane block (SAPB) were used to ensure intraoperative and postoperative analgesia. The procedure was well tolerated, demonstrating TSA's potential advantages in minor thoracic surgery. This fusion approach may represent a safe and effective alternative to general anesthesia, reducing invasiveness and improving patient outcomes.