Experience of Twenty Cases of Anesthesia for Thoracoscopic Laser Therapy of Bullous Emphysema

Abstract

Laser ablation procedures under general anesthesia were performed in 20 patients. All patients complained of dyspnea at exercise or at rest. Mean preoperative FEV 1.0%, mean PaO₂ and mean PaCO₂ in room air were 31%, 71mmHg and 42mmHg, respectively. Induction of anesthesia was conducted with ketamine, midazolam and vecronium. Double lumen endtracheal tube was inserted. Anesthesia was maintained with isoflurane in 100% oxygen. We used pressure-controlled ventilation and limited peak airway presure to below 25cmH₂O. Cardio-pulmonary data were recorded 20min after intubation (TLV-1), 20min after one lung ventilation (OLV) and 20min after re-expansion of the operative lung (TLV-2). PaO₂ and tidal volume decreased from TLV-1 values to OLV values. Peak airway pressure and shunt increased from TLV-1 values to OLV values.