Non-intubated anaesthetic technique in open bilobectomy in a patient with severely impaired lung function

Zsolt Szabó, Tamás Tanczos, Gábor Lebak, Zsolt Molnár, József Furák

Research output: Contribution to journalArticle

Abstract

General anaesthesia has been the most commonly used method for almost all types of thoracic surgery. Recently, there has been a growing interest in non-intubated anaesthetic techniques. The rationale being, to prevent complications related to general anaesthesia and positive pressure ventilation such as barotrauma or ventilation-perfusion mismatch. We present a case with severely impaired forced expiration volume (26%), carbon monoxide diffusing capacity (26%) and VO2max (13.9 mL/kg/min). According to current guidelines, this patient was suitable to undergo one-lung ventilation only with high risk of morbidity and mortality. Therefore, we chose the non-intubated technique for thoracotomy. Oxygenation was satisfactory throughout, the patient remained hemodynamically stable and the operation was uneventful. Oxygen supplementation was stopped from day 2 and he was discharged on day 7. To our knowledge, this is the first case report where a planned non-intubated method was applied for thoracotomy, and our results suggest that it might be a feasible and safe approach for open thoracotomy in difficult cases where severely impaired lung function indicates that one lung ventilation may carry significant risks.

Original languageEnglish
Pages (from-to)E275-E280
JournalJournal of Thoracic Disease
Volume10
Issue number4
DOIs
Publication statusPublished - Apr 1 2018

Keywords

  • Impaired lung function
  • Lobectomy
  • Non-intubated thoracoscopy
  • Serratus block
  • Thoracotomy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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