General anesthesia in a case of traumatic total rupture of the left main bronchus

M. Sugimura, Y. Aratani, M. Irifune, Tohru Takarada, K. Maeoka, Y. Shimizu, M. Kawahara

Research output: Contribution to journalArticlepeer-review

Abstract

A 58-year-old man with a total rupture of the left main bronchus, received general anesthesia for invasive immobilization of the mandible on 16 days after a traffic accident. This complication was first indicated by postoperative atelectasis of the left lung. Immediately after the injury, the patient, 164 cm in height and 57 kg in weight, had undergone surgery for invasive immobilization to treat a fracture of the left elbow joint and managed with intrathoracic drainage under general anesthesia to improve his traumatic hemorrhagic pneumothorax. Prior to the oral surgery, examination failed to reveal any abnormal symptoms. During the operation, after premedication with atropine sulfate and hydroxyzine, anesthesia was induced with thiopental sodium, fentanyl and nitrous oxide oxygen isoflurane. After obtaining sufficient relaxation with vecronium, nasal endotracheal intubation was performed. Anesthesia was maintained with air oxygen isoflurane under controlled ventilation. Although the intraoperative circulatory course was almost entirely uneventful, we couldn't obtain an optimal PaO2 corresponding to FIO2. Postoperatively, the patient was hypoxic, even when given oxygen. The postoperative chest X P findings revealed pneumothorax, atelectasis in the left lung, and a mediastinal shift to left. The results of bronchoscopy and CT indicated a total occlusion of the left main bronchus in ICU. It was demonstrated by open chest surgery that this finding was due to a total rupture of the left main bronchus. The patient underwent bronchoplasty and achieved complete remission.

Original languageEnglish
Pages (from-to)809-814
Number of pages6
JournalJournal of Japanese Dental Society of Anesthesiology
Volume24
Issue number5
Publication statusPublished - 1996
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Dentistry(all)
  • Anesthesiology and Pain Medicine

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