Anesthesia for vanishing lung syndrome: report of a case

A patient with severe bullous emphysema in whom one bulla occupied an entire hemithorax and shifted the mediastinum to the opposite side was anesthetized for bullectomy in a lateral thoracotomy position using an awake intubation with a Bryce-Smith double-lumen endotracheal tube under spontaneous ventilation on room air. The maintenance anesthetic was halothane and oxygen, with pancuronium bromide for relaxation and ventilation of the good lung only. This technique avoids many of the potential problems presented by this type of patient.