Single-lung ventilation for pulmonary lobe resection in a newborn.

UNLABELLED: The increasing frequency of video-assisted thoracoscopic interventions as well as open thoracic surgical procedures in children demands appropriate anesthetic techniques to provide single-lung ventilation. A fiberoptically directed, wire-guided 5F endobronchial blocker for use in small infants has recently been devised. We report on the very special aspects of airway management in a newborn 3000-g infant who presented a major anesthetic and surgical challenge because of congenital emphysema of the left upper pulmonary lobe. IMPLICATIONS: The special aspects of single-lung ventilation in a newborn 3000-g infant who presented a major anesthetic and surgical challenge because of congenital emphysema of the left upper pulmonary lobe are reported.

Co-medications, pre-medication and common diseases in the elderly.

Typically, old patients scheduled to undergo a surgical procedure take many medications for various disorders. The anaesthetist must consider the benefits and/or risks of continuation or withdrawal of such chronic medications. This chapter reviews these issues in respect of cardiovascular drugs (calcium channel blockers, beta adrenoreceptor antagonists, angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists) and of psychotropic and antiparkinson medications and insulin. Focus is put on the few scientific studies available and on the recommendations given by experts in the field.