Anesthesia for Thoracoscopic Surgery in Patients Under Home Oxygen Therapy

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 18; no. 2; pp. 173 - 176
• Main Authors: NAGAKAWA, Tamotsu, KAMITANI, Kazuo, YOSHIDA, Hitoshi, HIGUCHI, Akiko, TAKEHANA, Keiko, YONEYAMA, Eiichi
• Format: Journal Article
• Language: English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 1998
• Subjects: Anesthetic management; Home oxygen therapy; Thoracoscopic operation
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.18.173

Two patients under home oxygen therapy underwent thoracoscopic surgery. One was managed by thoracic epidural anesthesia to maintain spontaneous respiration during the surgery and the other was managed by general anesthesia in combination with epidural anesthesia. Case 1: A 62-year-old man who had multiple emphysematous bullae in his left lung and pneumothorax in his right lung underwent laser ablation of the right lung via thoracoscope. Anesthesia was maintained by thoracic epidural anesthesia. During the operation, the patient complained of discomfort when in the lateral decubitus position, which limited the extent of the operation. After the operation, the lung did not reexpand fully and air leakage continued. Case 2 : A 64-year-old man had an expanding bulla in his right lung with multiple bullae in both lungs. He underwent thoracoscopic operation of the right lung. General anesthesia in combination with epidural anesthesia was maintained. Postoperative artificial ventila-tion was needed for 5 days. The re-expansion of his lung was satisfactory.