Excision of a giant hydatid cyst of the lung under thoracic epidural anaesthesia.
We present a patient with a large pulmonary hydatid cyst compressing underlying lung, with previous pulmonary tuberculosis, who presented in respiratory failure. After institution of thoracic epidural anaesthesia employing 0.25% bupivacaine, 1% lignocaine and fentanyl, the patient was placed in the sitting position and the hydatid cyst excised and drained after a limited rib resection. An air leak persisted until the 16th postoperative day. A marked improvement in symptoms as well as in spirometly and arterial blood gases occurred, and the patient was discharged on the 20th day. Thoracic epidural anaesthesia may be a safer method than general anaesthesia for removal of a hydatid cyst in a patient with severe respiratory compromise.
Dyer
R A
RA
Department of Anaesthesia, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
Gordon
P C
PC
De Groot
K M
KM
Walther
G
G
James
M F
MF
D000759:Adjuvants, Anesthesia; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local; D002045:Bupivacaine; D004445:Echinococcosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005283:Fentanyl; D006801:Humans; D008012:Lidocaine; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D009407:Nerve Block; D011859:Radiography; D012131:Respiratory Insufficiency / Q000150:complications; D013909:Thorax; D014397:Tuberculosis, Pulmonary / Q000150:complications
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl; D002045:Bupivacaine