Anesthesia in a Patient with Diaphragmatic Hernia and Obstructive Sleep Apnea: Case Report

Abstract

Traumatic diaphragmatic hernia (TDH) is a serious, frequently overlooked complication observed secondary to a thoracoabdominal trauma. The treatment of TDH is surgical and diaphragmatic repair, usually performed with a thoracotomy approach. During a thoracotomy, the lung on the operation side is collapsed and single-lung ventilation is employed. This procedure facilitates the work of the surgeon; however, it makes the administration of anesthesia more difficult. Obstructive sleep apnea (OSA) is a disorder characterized by attacks of apnea and hypopnea due to partial or complete obstruction of the upper respiratory tract during sleep. Administration of anesthesia to patients with OSA involves several difficulties with respect to ventilation and intubation, as well as potential respiratory complications during the postoperative period. In this case report, critical issues faced during the administration of anesthesia to a 46-year-old male patient with OSA who was diagnosed with TDH 1 year after a trauma were discussed in the context of the literature.