Korean J Anesthesiol.  1999 Mar;36(3):540-546. 10.4097/kjae.1999.36.3.540.

Anesthetic Considerations in a COPD Patient with 0.38 L of FEV1: A case report

• Park SH
• Chin CH
• Kim KH

• KMID: 2032301
• DOI: http://doi.org/10.4097/kjae.1999.36.3.540

Abstract

It is difficult to determine respiratory criteria of fitness for surgery and anesthesia in patients with intractable chronic obstructive pulmonary disease (COPD), who have high mortality and morbidity in the perioperative period. Also, it is commonly assumed that general anesthesia carries a greater risk of perioperative pulmonary complications than regional anesthesia in patients with COPD. A 79-yr-old COPD female patient complaining of right hip pain due to fracture of right femur neck and dyspnea on rest was admitted for surgery. Even after aggressive medical management for COPD during the preoperative period, dyspnea on rest and expiratory wheezing were not improved. The results of the pulmonary function test and the immediate preoperative arterial blood gas analysis were as follows: FVC 0.97 L, FEV1 0.38 L, FEF25-75% 0.11 L/sec, PaO2 47.6 mmHg, and PaCO2 68 mmHg. We report the anesthetic considerations for the epidural block for the severe COPD patient associated with hypoxemia and hypercarbia.

Keyword

Anesthetic techniques, epidural, lumbar; Lung, obstructive pulmonary disease

MeSH Terms

Anesthesia
Anesthesia, Conduction
Anesthesia, General
Anoxia
Blood Gas Analysis
Dyspnea
Female
Femur Neck
Hip
Humans
Mortality
Perioperative Period
Preoperative Period
Pulmonary Disease, Chronic Obstructive*
Respiratory Function Tests
Respiratory Sounds