Anaesthesia for the patient with a coincidental giant lung bulla: a case report

The anaesthetic management of a patient with a coincidental giant lung bulla who underwent lumbar discectomy and laminectomy is described. The specific problems associated with anaesthesia in patients wih bullae, such as acute enlargement or rupture of the bullae, are discussed. Precautionary measures which may be taken during anaesthesia include the avoidance of nitrous oxide, the prophylactic use of a double-lumen tube, and the immediate availability of chest drains in the anaesthetizing area. Monitoring during operation may involve bilateral chest auscultation and arterial blood gas analysis.