Abstract
A 67-year-old female patient was scheduled for colectomy. Subclavian vein catheter was inserted under local anesthesia one week before the operation. The postinsertion chest X-ray film did not detect a pneumothorax, and the patient did not complain of chest pain or respiratory distress. Anesthesia was induced with propofol and maintained with nitrous oxide/sevoflurane and epidural anesthesia. During the surgery, airway pressure was almost normal, and the value of pulse oximetry was almost stable at around 97%. After extubation, the value of the pulse oximetry decreased remarkably and became 89%. Right pneumothorax was found on a chest X-ray, and at thoracic drainage tube was inserted. In a patient with subclavian vein catheterization, even if the catheter was inserted a week ago, it is necessary to take care not to overlook intraoperative delayed pneumothorax due to positive pressure ventilation and administration of nitrous oxide.
