Anaesthetic management of patients undergoing lung volume reduction surgery for treatment of severe emphysema.

Lung volume reduction surgery can improve lung function in patients with emphysema. We report our anaesthetic experience, problems and the physiological data of eight patients. Our aims were prevention of air trapping and air leaks, good analgesia and early recovery and mobilization. We were able to achieve these aims using pressure limited ventilation, lumbar epidural diamorphine, propofol infusions and intensive physiotherapy. Hypoxia during one-lung ventilation was the main intraoperative problem. Air leaks, infection and pulmonary hypertension were the main postoperative problems.