[Anesthesia for surgical intervention in recurrent pneumothorax in a patient with one lung]

A 56 year old man was scheduled for partial resection of the right lung because of many spontaneous pneumothorax episodes. He had received left pneumonectomy for pulmonary tuberculosis and his respiratory function was severely depressed. During anesthesia, pulse oximetry, pulmonary arterial pressure monitoring, pulmonary arterial oximetry in addition to ordinary systemic arterial pressure and electrocardiogram monitoring were performed. Anesthesia was maintained with fentanyl and enflurane, and nitrous oxide was added after thoracotomy. During thoracotomy SpO2 and SVO2 dropped transiently, but intraoperative course was uneventful except an episode of paroxysmal atrial tachycardia. A successful satisfactory anesthetic management of this case depended on the cooperation between anesthesiologist and surgeon, and the appropriate monitoring especially of SVO2 was helpful.