title: Use of continuous positive airway pressure during spinal anaesthesia in a patient with severe chronic obstructive pulmonary disease.
abstract: We report the case of a patient with severe chronic obstructive pulmonary disease who underwent local resection of a carcinoma of the rectum under spinal anaesthesia. Although the patient was keen to avoid general anaesthesia and to have the operation under a spinal anaesthetic, pre-operative assessment showed that he could not lie flat. As the surgical procedure required the patient to be in the lithotomy position, ideally with a head-down tilt, it was hoped that continuous positive airway pressure with a facemask during spinal anaesthesia might help him to tolerate the position comfortably. Continuous positive airway pressure at 7.5 cmH(2)O was successfully used to facilitate breathing during surgery under spinal anaesthesia. A combination of regional anaesthesia and continuous positive airway pressure via a facemask is easy to use and may be a useful option in the management of these challenging patients.
authors.affiliation: Arrowe Park Hospital, Upton, UK. pbapat@hotmail.com
authors.forename: P P
authors.initials: PP
authors.lastname: Bapat
authors.forename: J A
authors.initials: JA
authors.lastname: Anderson
authors.forename: S
authors.initials: S
authors.lastname: Bapat
authors.forename: A
authors.initials: A
authors.lastname: Sule
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018475:Head-Down Tilt; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012004:Rectal Neoplasms / Q000601:surgery