Anesthetic Management of a Patient with Thoracic Spine Tumor by One-Lung Ventilation in the Prone Position

Abstract

  A 21-year-old man diagnosed with thoracic spine tumor was scheduled for resection of the thoracic tumor and posterior thoracic spinal fixation. This operation had to be performed on one-lung ventilation in a prone position. We used a four-point support frame to maintain dynamic compliance and used rigid head pin fixation to secure the working space. Hypoxemia during one-lung ventilation was treated using continuous positive airway pressure in the non-ventilated lung. An understanding of respiratory physiology is essential for one-lung ventilation in a prone position and management of disturbances in ventilation-perfusion matching caused by hypoxic pulmonary vasoconstriction.