Anaesthesia for bullectomy. A technique with spontaneous ventilation and extradural blockade.
A patient with severe bullous emphysema in whom one bulla occupied more than 25% of the hemithorax, with a shift of the mediastinum to the opposite side, was anaesthetised for bullectomy with a combination of intravenous gamma-hydroxybutyric acid and a high thoracic extradural catheter technique. During the operation the patient breathed 100% oxygen through a double-lumen endobronchial tube in the lateral thoracotomy position. Extradural analgesia during the operation was provided by bupivacaine 0.25%, with adrenaline 1:200 000 and, postoperatively, with nicomorphine diluted in dextrose 5%. The advantages of this technique are described.
D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D002045:Bupivacaine; D004837:Epinephrine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000601:surgery*; D012119:Respiration; D012129:Respiratory Function Tests; D012978:Sodium Oxybate
D012978:Sodium Oxybate; D002045:Bupivacaine; D004837:Epinephrine