title: [Awake epidural anesthesia for thoracotomic drainage in a high-risk patient with postoperative severe pneumonia complicated with empyema].
abstract: An 84-year-old man successfully underwent thoracotomic drainage for empyema under awake epidural anesthesia. His past history had revealed significant chronic obstructive pulmonary disease due to smoking. He had undergone right lower lobectomy a month before, but his postoperative course was complicated with pulmonary leakage, severe pneumonia and empyema which required intensive care management. A thoracotomic drainage for empyema was managed under awake thoracic epidural anesthesia using fentanyl and 1% lidocaine because of concern about deterioration of respiratory status following general anesthesia. The additional small doses of fentanyl i. v. and local anesthesia infiltration were needed for resection of 9th rib, but otherwise the drainage was managed successfully. Awake epidural anesthesia was very useful for such a high-risk patient with poor respiratory status.
authors.affiliation: Department of Anesthesia, Sakai Municipal Hospital, Sakai 590-0064.
authors.forename: Ryota
authors.initials: R
authors.lastname: Aoi
authors.forename: Michihiko
authors.initials: M
authors.lastname: Kouno
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Kohata
authors.forename: Kan
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000379:methods*; D004322:Drainage / Q000379:methods*; D004653:Empyema / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000209:etiology*; D011183:Postoperative Complications; D013908:Thoracotomy