Abstract
A 30-year-old woman in the 20th gestational week developed right-sided spontaneous pneumothorax. Chest tube drainage was performed, but air leakage continued. At the 24th gestation, video-assisted thoracoscopic bullectomy was performed. General anesthesia was induced with thiopental, vecuronium and fentanyl and, maintained with sevoflurane. Endobronchial intubation with a 32Fr double-lumen tube was successful. After changing to the left lateral position, epidural catheter was placed and mepivacaine 2% was administered. During one-lung ventilation, SpO2 remained 100% but end-tidal CO2 was elevated to 66 mmHg. Ephedrine 15 mg was required to maintain systolic blood pressure above 100 mmHg. After the surgery, continuous injection of levobupivacaine 0.18% was started through the catheter. When patient complained of pain, 3 ml bolus injection was administered. In our case, one-lung ventilation led to hypercapnia, but avoided prolonged fetal acidosis by returning to bilateral lung ventilation.
