Abstract:

The anesthetic management of patients with bullous emphysema undergoing laparoscopic surgery is challenging due to the life-threatening complications that might occur from bullae rupture during anesthesia induction, maintenance, and emergence. However, successful management can be achieved when the proper measures are taken. Intraoperatively, nitrous oxide should be avoided, lungs ventilated using pressure-control ventilation, peak inspiratory pressure maintained at or around 15 cm H?O, frequent auscultations performed and arterial blood gases taken repetitively. A chest tube should be readily available inside the operating theatre with the on call cardiothoracic surgeon in close reach