[Anesthesia for thoracotomy in a patient with severe emphysema associated with Wolff-Parkinson-White syndrome].
[Anesthesia for thoracotomy in a patient with severe emphysema associated with Wolff-Parkinson-White syndrome].
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Original abstract
A 57-yr-old man with Wolff-Parkinson-White syndrome was scheduled for thoracotomy due to pneumothorax caused by severe emphysema (FEV1.0% 29%). Anesthesia was induced with propofol and fentanyl and maintained with continuous propofol infusion combined with thoracic epidural anesthesia. During mechanical ventilation, the peak inspiratory pressure was reduced to avoid overinflation or rupture of the lung. Although severe hypercapnia was observed during one lung ventilation, there was no incidence of tachyarrhythmias that we had feared. We suggest that hypercapnia is unlikely to cause tachyarrhythmias in patients with WPW syndrome if carefully managed.