Anesthetic Management of a Patient with Giant Emphysematous Bullae undergoing Bullectomy with Lobectomy: A Case Report

JOURNAL TITLE: Research & Innovation in Anesthesia

Author
1. Lavanya Thakur
2. Raghbirsingh Gehdoo
ISSN
DOI
10.5005/jp-journals-10049-2014
Volume
7
Issue
2
Publishing Year
2022
Pages
3
  • Article keywords
    Anesthesia, One lung ventilation, Postoperative pulmonary complications, Thoracotomy

    Abstract

    Introduction: Bullae are thin-walled, air filled intraparenchymal lung spaces caused by the loss of alveolar structural tissue. Giant bulla refers to the one that occupies more than 30% of the hemithorax. After the thorough clinical and radiological assessment, patients with bulla can be taken up for surgeries like local excision/bullectomy, lobectomy, segmental resection, and minimal access surgery technique with laser and videoscopy. Case presentation: An atypical case of a 48-year-old female with a giant bulla measuring 14.2 x 9.7 x 13.7 cm almost completely involving left lung with passive collapse of left upper lobe, managed successfully using lung isolation technique and a well planned post-operative pain management. Conclusion: Anesthetist should consider an extensive preoperative evaluation to identify the high risk factors, reversibility of underlying lung disease and stratify a successful perioperative management with a smooth, pain free post-operative recovery in such patients.

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