Desaturaton due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Patient Who Underwent the Cephalic Vein Bypass Surgery under Epidural Anesthesia

Abstract

A 72-year-old man with chronic renal failure underwent cephalic vein bypass surgery. He also had diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. To avoid the exacerbation of chronic obstructive pulmonary disease, the surgery began under epidural anesthesia with no sedation and oxygen supply via simple mask. During the surgery, desaturation occurred abruptly to 83%. Desaturation continued after intubation for a while and slowly disappeared as time went by. After the surgery, in the intensive care unit we performed a bronchoscopic examination and found large amount of sputum in both bronchioles. After bronchial suction and toileting, extubation was performed. In the patient with chronic obstructive pulmonary disease, it is possible that desaturation occurs abruptly due to acute exacerbation, although the surgery is conducted under epidural anesthesia with no sedation. Key words: Epidural anesthesia; Acute exacerbation; Chronic obstructive pulmonary disease