title: [Respiratory management for a patient with a giant bulla and pulmonary dysfunction during off-pump coronary artery bypass grafting].
abstract: This case report describes a successful anesthetic management of a 74-year-old patient with a giant bulla and pulmonary dysfunction during off-pump coronary artery bypass grafting (OPCAB). BiPAP Vision with a laryngeal mask airway (LMA) was used for intraoperative respiratory management. General anesthesia was induced with propofol. After insertion of a LMA anesthesia was maintained with propofol and dexmedetomidine under spontaneous breathing with bilevel positive airway pressure. Epidural analgesia was used in combination with general anesthesia. The LMA was removed without coughing and bucking soon after the end of the surgery. There was no complication during and after anesthesia. This respiratory management may be beneficial for patients with a giant bulla and pulmonary dysfunction during OPCAB.
authors.affiliation: Department of Anesthesia, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902.
authors.forename: Kikuko
authors.initials: K
authors.lastname: Suga
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoshida
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kamada
authors.forename: Ryo
authors.initials: R
authors.lastname: Takao
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kaneko
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D000768:Anesthesia, General; D001768:Blister / Q000150:complications* / Q000503:physiopathology; D047549:Coronary Artery Bypass, Off-Pump; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D017214:Laryngeal Masks; D008168:Lung / Q000503:physiopathology; D008171:Lung Diseases / Q000150:complications* / Q000503:physiopathology; D008297:Male; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D011656:Pulmonary Emphysema / Q000150:complications / Q000503:physiopathology; D012129:Respiratory Function Tests