Anesthetic Management in Children with Congenital Lobar Emphysema.
BACKGROUND
The cause of congenital lobar emphysema (CLE) is unknown and characterized by hyperinflation of one or more lobes of the lung. The purpose of this retrospective study was to present the anesthetic management of children with congenital lobar emphysema (CLE) receiving treatment in our center.


METHODS
Ten children underwent CLE-related surgical treatment in our center between March 1995 and August 2014. All cases were diagnosed on the basis of postero-anterior chest radiography and computerized tomography. Age, sex, preoperative clinical findings, location of lesions, surgical and anesthetic procedures, results of anesthesia and duration of hospitalization were evaluated.


RESULTS
Six patients were male (60%) and four female (40%). Their ages ranged from 40 days to 6 years. Dyspnea was present in all cases and severe in four of them. Four patients had emphysema in the left upper lobe, three in the right middle lobe, one in the right upper lobe and one in the left lower lobe. All patients were extubated in the operating room and none experienced post-operative respiratory distress. Post-operative analgesia was provided via the previously placed intrapleural catheter. All the patients were extubated in the operation room. There was no post-operative mortality or morbidity.


CONCLUSIONS
Anesthetic management of patients with CLE is challenging. In these patients the surgical team and -anesthetists should collaborate closely and the time between anesthesia induction and thoracotomy should be as short as possible.
Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Palandoken, Erzurum, Turkey.
M
M
Celik
A
A
Dostbil
M
M
Aksoy
H A
HA
Alici
N
N
Dogan
I
I
Ince
Y
Y
Aydin
A
A
Ahiskalioglu
D060666:Airway Extubation; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000077335:Desflurane; D004417:Dyspnea / Q000209:etiology; D004646:Emphysema / Q000151:congenital* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007430:Intraoperative Care; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use; D009873:Operating Rooms; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D002045:Bupivacaine