[Anesthesia for partial pulmonary resection in a postpneumonectomy patient].
We experienced anesthesia for partial pulmonary resection in a postpneumonectomy patient. A 59 year-old woman underwent left upper lobectomy 5 years earlier and left lower lobectomy 2 years earlier for lung cancer, respectively. Right segmental pulmonary resection was proposed for lung cancer. Preoperative examinations revealed decreased FVC (1.81 l) and FVC1 (1.57 l), and increased PaCO2 (48.4 mmHg). The patient was monitored with EKG, direct arterial pressure, central venous pressure, pulse oxymetry and expired gas analysis. Anesthesia was induced with thiopental and fentanyl, and maintained with sevoflurane, propofol and supplemental fentanyl after the establishment of epidural anesthesia. Dopamine was continuously infused due to decreased blood pressure. Then hemodynamics was stable. Operative procedure was protective. Therefore SPO2 was kept above 98% during the operation. Partial resection was performed instead of segmental resection to avoid deteriorating the postoperative quality of life. The postoperative course was uneventful.
Kishi
Yoshihiko
Y
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511.
Taniguchi
Hiroshi
H
Nakagawa
Masashi
M
Kita
Takashi
T
Mammoto
Tadanori
T
Kanbara
Noriko
N
Sakai
Toshiko
T
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D013997:Time Factors