[A case report of anesthesia for concomitant right pneumonectomy and coronary artery bypass operations]

A 61-year-old man with previous myocardial infarction, was diagnosed as having lung cancer. Coronary arteriogram revealed stenoses of left anterior descending artery. We did the concomitant pulmonary and cardiac operations. Anesthesia was induced with fentanyl 1.5 mg and pancuronium 6 mg. A 37 Fr double-lumen endotracheal tube was inserted. Then a pulmonary artery catheter was inserted. The patient was given nitroglycerin for prevention of myocardial ischemia. The tumor had invaded pulmonary artery and therefore right pneumonectomy was necessary. After resection of right lung, coronary artery bypass operation was performed. On weaning from cardio-pulmonary bypass, pulmonary artery pressure increased to 48/20mmHg. Therefore he required dopamine and dobutamine each 4 micrograms.kg-1.min-1 for weaning. But we experienced no serious complications such as hypoxemia or perioperative myocardial infarction.