Anaesthesia and postoperative pain management for bilateral lung volume reduction surgery

Bilateral lung volume reduction surgery was introduced into Australia in 19 95 for treatment of selected patients with emphysema. We present our experi ence of the anaesthetic management of our first 55 cases and describe facto rs associated with outcome. There were four postoperative deaths (7%). Mean (SD) total operation time was 231 (72) minutes. Median intensive care unit (ICU) stay was 26 hours. There was a significant improvement in postoperat ive lung function (FEV1, VC, 6-minute walk test, all P < 0.001). Eight pati ents (15%) required reintubation for respiratory failure; three of these pa tients subsequently died. With multivariate analysis, total operation time was the only significant predictor of length of ICU stay R-2 = 0.25, P = 0. 001), which itself was the only significant predictor of hospital stay dura tion (R-2 = 0.36, P < 0.001).