title: Anaesthesia and postoperative pain management for bilateral lung volume reduction surgery.
abstract: Bilateral lung volume reduction surgery was introduced into Australia in 1995 for treatment of selected patients with emphysema. We present our experience of the anaesthetic management of our first 55 cases and describe factors associated with outcome. There were four postoperative deaths (7%). Mean (SD) total operation time was 231 (72) minutes. Median intensive care unit (ICU) stay was 26 hours. There was a significant improvement in postoperative lung function (FEV1, VC, 6-minute walk test, all P < 0.001). Eight patients (15%) required reintubation for respiratory failure; three of these patients subsequently died. With multivariate analysis, total operation time was the only significant predictor of length of ICU stay R2 = 0.25, P = 0.001), which itself was the only significant predictor of hospital stay duration (R2 = 0.36, P < 0.001).
authors.affiliation: Department of Anaesthesia and Pain Management, Alfred Hospital, Melbourne, Victoria.
authors.forename: A U
authors.initials: AU
authors.lastname: Buettner
authors.forename: R
authors.initials: R
authors.lastname: McRae
authors.forename: P S
authors.initials: PS
authors.lastname: Myles
authors.forename: G I
authors.initials: GI
authors.lastname: Snell
authors.forename: M A
authors.initials: MA
authors.lastname: Bujor
authors.forename: A
authors.initials: A
authors.lastname: Silvers
authors.forename: A M
authors.initials: AM
authors.lastname: Weeks
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010149:Postoperative Pain / Q000628:therapy*; D011183:Postoperative Complications; D011656:Pulmonary Emphysema / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate; D014797:Vital Capacity