[Anesthetic management of pneumonorrhaphy for one-lung patient]

Selective immobilisation of the lobes of the lungs with a bronchial blocker is sometimes a challenge for anesthesiologists. A pneumonorrhaphy was planned in a patient who had had undergone left pneumectomy, and selective immobilisation of the right upper lobe was requested. The initial attempt to place the cuff of a bronchial blocker was unsuccessful. We inserted a urethral guide-wire through fiberoptic bronchoscope and positioned the tip at the orifice of the right upper bronchus. We then threaded the bronchial blocker through the guidewire and placed the cuff at the right upper bronchus. The right upper lobe was successfully collapsed, which greatly facilitated the surgical procedure. The method is easy, fast, and safe and should be considered when difficulty in placement of the bronchial blocker is encountered.