One - Lung Anesthesia for the Thoracoscopy

Kim, Chi Hyo; Kim, Jong Hak; Lee, Choon Hi; Im, Keum Ah

Abstract

One lung ventilation with a double lumen endobronchial tube during thoracic anesthesia is necessary for the protection of the healthy lung from eontamination by spilage of aecretion from the diseased lung and for offering acceptable condition for the surgeon. In this study, 15 ASA Class 1 & 2 patients who were scheduled for thoracoscopy by one lung ventilation were selected. they were intubsted with a double lunen endobmnchial tube and were ventilated with 100% oxygen. Arterisl blood gases were analysed, and mean arterial pressure and pulse rate were measured at tbree stages (stage I: two-lung ventilation after anesthetic induction and intubation, and 15 min after positioning to lateral decubitus, stage IL: one-lung ventilation, 15 min after lung collapse, and stage III: two-lung ventilation, 15 min after reinflation of operative lung ). Arterial blood gas analysis shows tbat pH and base excess decreased significantly at stage III compaired with those of stage I (p<0.05). Arterial oxgen tension decreased significantly at stage II but was not signifieant clinically, and arterial carbon dioxide tension and oxygen saturation did not change signifieantly at all stages. Mean arterial pressure increased significantly at stageII compaired with that of stage I (p <0.05) without clinical significance, and heart rate also incre significantly at stage III compsired with that of stage I (p<0.05) without clinical significance. We concluded that when thoracoscopy was performed in lateral decubitus poaition by use of one-lung ventilation with 100% oxygen.