Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV

2016 ◽  
Vol 30 (4) ◽  
pp. 961-966 ◽  
Author(s):  
Izumi Kawagoe ◽  
Masakazu Hayashida ◽  
Kenji Suzuki ◽  
Yoshitaka Kitamura ◽  
Shiaki Oh ◽  
...  
Keyword(s):  
Anesthetic Management ◽  
Lung Ventilation ◽  
Lung Surgery ◽  
One Lung Ventilation ◽  
Left Upper Lobectomy ◽  
Selection Of

scholarly journals Effect of Thoracic Epidural Anesthesia with Different Concentrations of Ropivacaine on Arterial Oxygenation during One-lung Ventilation

2010 ◽  
Vol 112 (5) ◽  
pp. 1146-1154 ◽  
Author(s):  
Yajun Xu ◽  
Zhiming Tan ◽  
Shilai Wang ◽  
Haijun Shao ◽  
Xuqin Zhu
Keyword(s):  
Epidural Anesthesia ◽  
Arterial Oxygen Tension ◽  
Lung Ventilation ◽  
Saline Group ◽  
Lung Surgery ◽  
Thoracic Epidural Anesthesia ◽  
Arterial Oxygen ◽  
One Lung Ventilation ◽  
Thoracic Epidural ◽  
Double Blinded

Background Thoracic epidural anesthesia can contribute to facilitate the fast-track approach in lung surgery. However, data regarding the effects of thoracic epidural anesthesia on oxygenation during one-lung ventilation (OLV) are scarce and contradictory. Therefore, the authors conducted a prospective, randomized, double-blinded trial in patients undergoing lung surgery under spectral entropy-guided intravenous anesthesia to evaluate the effects of thoracic epidural anesthesia with different concentrations of ropivacaine on oxygenation, shunt fraction (Qs/Qt) during OLV, and maintenance doses of propofol. Methods One hundred twenty patients scheduled for lung surgery were randomly divided into four groups to epidurally receive saline (Group S), 0.25% (Group R0.25), 0.50% (Group R0.50), and 0.75% (Group R0.75) ropivacaine. Ropivacaine was administered intraoperatively (6-8 ml of first bolus + 5 ml/h infusion). Arterial oxygen tension (Pao2) and Qs/Qt were measured before, during, and after OLV. Results Pao2 was significantly lower in Group R0.75 compared with that in Group S and Group R0.25 10 min (170 +/- 61 vs. 229 +/- 68 mmHg, P = 0.01; 170 +/- 61 vs. 223 +/- 70 mmHg, P = 0.03) and 20 min after OLV (146 +/- 52 vs. 199 +/- 68 mmHg, P = 0.009; 146 +/- 52 vs. 192 +/- 67 mmHg, P = 0.03). During OLV, Qs/Qt was significantly higher in Group R0.75 compared with that in Group S and Group R0.25 (P < 0.05). Maintenance doses of propofol were significantly lower in Group R0.75. Vasopressor requirements were higher in Group R0.75. Conclusion A decrease in oxygenation during OLV occurred only at the highest dose of epidural local anesthetic and not at lower doses. Higher doses of epidural medication required less propofol and more vasopressors.

The effect of hypercapnia and hypertension on cerebral oxygen balance during one-lung ventilation for lung surgery during propofol anesthesia

2010 ◽  
Vol 22 (8) ◽  
pp. 608-613 ◽  
Author(s):  
Masato Iwata ◽  
Satoki Inoue ◽  
Masahiko Kawaguchi ◽  
Michitaka Kimura ◽  
Takashi Tojo ◽  
...  
Keyword(s):  
Lung Ventilation ◽  
Lung Surgery ◽  
Cerebral Oxygen ◽  
Oxygen Balance ◽  
One Lung Ventilation ◽  
Cerebral Oxygen Balance

Congenital Pulmonary Airway Malformation

2018 ◽  
Author(s):  
Alina Lazar
Keyword(s):  
Thoracic Surgery ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Cardiovascular Complications ◽  
Positive Pressure ◽  
Clear Understanding ◽  
One Lung Ventilation ◽  
Lung Isolation ◽  
Isolation Techniques ◽  
Lung Abnormalities

Respiratory distress in infants may be caused by perinatal events and physiologic changes (e.g., lung immaturity, meconium aspiration, and persistent pulmonary hypertension); infectious processes; cardiovascular, neurologic, and metabolic abnormalities; as well as congenital lung abnormalities. Some of these may coexist, further complicating the diagnosis, clinical course, and management of the affected infant. Sound anesthetic management of congenital lung abnormalities requires a clear understanding of the pathophysiology of lung lesions and, in particular, the consequences of positive-pressure ventilation in patients with cystic and emphysematous lesions. Also critical is an appreciation for the physiologic differences in children undergoing thoracic surgery, indications for one-lung ventilation, age-appropriate lung isolation techniques, potential respiratory and cardiovascular complications that may occur during pediatric thoracic surgery, and the optimal choices for postoperative analgesia.

scholarly journals The Effects of Iloprost on Oxygenation During One-Lung Ventilation for Lung Surgery: A Randomized Controlled Trial

2019 ◽  
Vol 8 (7) ◽  
pp. 982 ◽  
Author(s):  
Hoon Choi ◽  
Joonpyo Jeon ◽  
Jaewon Huh ◽  
Jungmin Koo ◽  
Sungwon Yang ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Controlled Trial ◽  
Venous Blood ◽  
Lung Ventilation ◽  
Lung Surgery ◽  
Control Group ◽  
One Lung Ventilation ◽  
Arterial Blood ◽  
Pulmonary Vasodilator ◽  
Inhaled Iloprost

Hypoxemia can occur during one-lung ventilation (OLV) in thoracic surgery, leading to perioperative complications. Inhaled iloprost is a selective pulmonary vasodilator with efficacy in patients with pulmonary hypertension. The purpose of this study was to evaluate the effects of off-label inhaled iloprost on oxygenation during OLV in patients undergoing lung surgery. Seventy-two patients who were scheduled for elective video-assisted thoracoscopic lobectomy were assigned to receive an inhaled nebulizer of distilled water (control group), 10 μg iloprost (IL10 group), or 20 μg iloprost (IL20 group). Arterial and venous blood gas and hemodynamic analyses were obtained. Changes in partial pressure of oxygen in arterial blood (PaO2), after the initiation of OLV and the resumption two-lung ventilation (TLV), were similar in all three groups. However, PaO2 in the IL10 group was comparable to that in the control group, whereas PaO2 in the IL20 group was significantly higher than that in the control group at 10, 20, and 30 min after administration of iloprost (275.1 ± 50.8 vs. 179.3 ± 38.9, p < 0.0001; 233.9 ± 39.7 vs. 155.1 ± 26.5, p < 0.0001; and 224.6 ± 36.4 vs. 144.0 ± 22.9, p < 0.0001, respectively). The shunt fraction in the IL20 group was significantly higher than that in the control group after administration of iloprost (26.8 ± 3.1 vs. 32.2 ± 3.4, p < 0.0001; 24.6 ± 2.2 vs. 29.9 ± 3.4, p < 0.0001; and 25.3 ± 2.0 vs. 30.8 ± 3.1, p < 0.0001, respectively). Administration of inhaled iloprost during OLV improves oxygenation and decreases intrapulmonary shunt.

One Lung Ventilation in a Patient with Central Airway Obstruction: Fluoroscopic Guided Bronchial Blocker Placement

2021 ◽  
Author(s):  
Ankit A Gupta
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Traditional Approach ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Bronchial Blocker ◽  
One Lung Ventilation ◽  
Central Airway Obstruction ◽  
Thyroid Mass ◽  
Central Airway

Thyroidectomy is the most common endocrine surgical treatment performed worldwide. Medullary thyroid carcinoma which accounts for less than 1.5 percent of these cases is different from other types of thyroid cancers in a way that it is a neuroendocrine malignancy that originates from the parafollicular C cells of the thyroid gland secreting calcitonin and it frequently spreads to lymph nodes and other organs. Anesthetic management in a case of a large thyroid mass with central airway obstruction is a task cut out for an anesthesiologist and the need to provide one-lung ventilation in these patients for thoracoscopic dissection of mediastinal lymph nodes adds to the challenges. In this case report, we describe fluoroscopic guided bronchial blocker placement as a novel technique for delivering one-lung ventilation in such patients, when the traditional approach of bronchial blocker placement with concomitant use of a fiber optic bronchoscope was not practicable due to the small size of the endotracheal tube in the presence of central airway obstruction.

Sign in / Sign up

Export Citation Format

Share Document