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2025, Number 4

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Rev Mex Anest 2025; 48 (4)

Intravenous anesthesia and protective one-lung ventilation for pulmonary hernia repair

Hernández-Santibañez R, Pérez-González OR, Cabildo-Clemente KI, Pérez-Montecinos G

Language: Spanish
References: 20
Page: 261-265
PDF size: 1255.39 Kb.


ABSTRACT

Introduction: pulmonary hernia, although uncommon, poses a challenge in anesthetic management during surgical repair due to the attention required in one-lung ventilation, pulmonary collapse, patient positioning, as well as the risk of lung injury and chronic pain. Case report: we present the case of a 56-year-old male patient with pain and bruising in the right hemithorax, diagnosed with pulmonary hernia through computed tomography. For the anesthetic event, total intravenous anesthesia with selective unipulmonary intubation and right paravertebral block for analgesia was chosen. Midazolam, fentanyl, cisatracurium, and propofol were administered for induction, followed by controlled mechanical ventilation, and after thoracotomy incision, one-lung ventilation was initiated. Remifentanil, dexmedetomidine, and propofol were used for anesthetic maintenance, and paracetamol, ketorolac, dexamethasone, and tramadol were administered as analgesics. The technique resulted in hemodynamic stability without adverse events and low postoperative pain. Conclusions: intravenous anesthesia and protective one-lung ventilation prove to be a safe and effective option in pulmonary hernia repair, providing hemodynamic stability and relief of postoperative pain.


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