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VOLUME 7 , ISSUE 2 ( July-December, 2022 ) > List of Articles


Anesthetic Management of a Patient with Giant Emphysematous Bullae undergoing Bullectomy with Lobectomy: A Case Report

Lavanya Thakur, Raghbirsingh Gehdoo

Keywords : Anesthesia, One lung ventilation, Postoperative pulmonary complications, Thoracotomy

Citation Information : Thakur L, Gehdoo R. Anesthetic Management of a Patient with Giant Emphysematous Bullae undergoing Bullectomy with Lobectomy: A Case Report. Res Inno Anesth 2022; 7 (2):53-55.

DOI: 10.5005/jp-journals-10049-2014

License: CC BY-NC 4.0

Published Online: 22-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Bullae are thin-walled, air filled intraparenchymal lung spaces caused by the loss of alveolar structural tissue. Giant bulla refers to the one that occupies more than 30% of the hemithorax. After the thorough clinical and radiological assessment, patients with bulla can be taken up for surgeries like local excision/bullectomy, lobectomy, segmental resection, and minimal access surgery technique with laser and videoscopy. Case presentation: An atypical case of a 48-year-old female with a giant bulla measuring 14.2 x 9.7 x 13.7 cm almost completely involving left lung with passive collapse of left upper lobe, managed successfully using lung isolation technique and a well planned post-operative pain management. Conclusion: Anesthetist should consider an extensive preoperative evaluation to identify the high risk factors, reversibility of underlying lung disease and stratify a successful perioperative management with a smooth, pain free post-operative recovery in such patients.

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  1. Dutta B, Gangaprasad. Anaesthetic management of a case of giant pulmonary bulla undergoing laparoscopic cholecystectomy. J Anesth Clin Res 2012;3(5):214. DOI: 10.4172/2155-6148.1000214
  2. Purohit A, Bhargava S, Mangal V, et al. Lung isolation, one-lung ventilation and hypoxaemia during lung isolation. Indian J Anaesth 2015;59(9):606–617. DOI: 10.4103/0019-5049.165855
  3. Saini V, Assu SM, Bhatia N, et al. Abdominal surgery in a patient with bullous emphysema: anesthetic concerns. J Anaesthesiol Clin Pharmacol 2019;35(3):414–415. DOI: 10.4103/joacp.JOACP_231_18
  4. Enright PL, Sherrill DL. Reference equations for the six–minute walk in healthy adults. Am J Respir Crit Care Med Am J Respir Crit Care Med 1998;158(5 Pt 1):1384–1387. DOI:10.1164/ajrccm.158.5.9710086. Erratum in: 2020;201(3):393.
  5. Ashok V, Francis J. A practical approach to adult one-lung ventilation. BJA Educ 2018;18(3):69–74. DOI: 10.1016/j.bjae.2017.11.007
  6. Karzai W, Schwarzkopf K. Hypoxemia during one-lung ventilation: prediction, prevention, and treatment. Anesthesiology 2009;110(6):1402–1411. DOI: 10.1097/ALN.0b013e31819fb15d
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