Anaesthesia and ventilation strategy in a horse undergoing pulmonectomy

Abstract

Summary A 7‐year‐old, 430 kg Standardbred gelding was presented to the hospital with severe bilateral purulent pleuropneumonia requiring partial pulmonectomy. Prior to surgery the trachea was intubated through a tracheotomy site using a customised tube (10 mm internal diameter)‐in‐tube (26 mm internal diameter) endotracheal tube, similar to a bronchial blocker tube in design. The left lung was selectively mechanically ventilated. Thoracotomy was performed and a major lung abscess and surrounding lung tissue were resected. Arterial PO2 and PCO2 remained 79–305 and 43–72 mmHg, respectively, and haemodynamic variables within a range acceptable for general anaesthesia in the horse. A 5 month follow‐up revealed complete resolution of the pleuropneumonia without signs of recurrence.

Een alternatief voor de ventilatie van één long tijdens thoracotomie bij een volwassen paard

“…The tracheal 'tube-in-tube' technique has been described for the functional separation of the lungs without tracheotomy (Moens et al, 1992). More recently, Bauquier et al (2010) performed OLV in a horse undergoing pulmonectomy with a customized tube via tracheotomy.…”

One lung anaesthesia for pulmonectomy in the horse

“…The Case Report by Bauquier et al (2010) in this issue describes the anaesthetic technique in a horse undergoing pulmonectomy and graphically illustrates some of the problems likely to be encountered. It is well established in medical anaesthesia that double lumen or bronchial blocker endotracheal tubes are essential for this procedure to be successful as is IPPV.…”

“…1992). In order to overcome the problems presented by the lack of a suitable tube, Bauquier et al. (2010) constructed one by passing a 10 mm tube through a 26 mm tube.…”

“…There is a recorded account of the construction of such a tube for experimental purposes in the horse (Moens et al 1992). In order to overcome the problems presented by the lack of a suitable tube, Bauquier et al (2010) constructed one by passing a 10 mm tube through a 26 mm tube. However, due to the short length of the tubes it was necessary to insert them through a tracheotomy in the lower third of the neck and to guide them into the appropriate bronchi with the aid of a fibre optic endoscope.…”

“…This is best provided with a combination of drugs, such as an opioid and nonsteroidal anti‐inflammatory drug, combined with local and regional anaesthesia with a long acting local anaesthetic drug. It has been demonstrated that by careful planning, minute attention to detail and the use of an improvised bronchial blocker that one lung anaesthesia is possible in horses (Bauquier et al. 2010).…”