General anaesthesia and undrained pneumothorax

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Summary: A patient who required pleurectomy had a 30% pneumothorax when she was presented for anaesthesia. She had refused to have this drained, and it had not responded to conservative management. She was anaesthetised using a computer‐controlled propofol infusion system, without the use of nitrous oxide, and a chest drain was inserted before the institution of positive pressure ventilation. This technique reduces the hazards associated with general anaesthesia in the presence of an undrained pneumothorax. It may be a safe alternative method of induction of anaesthesia in other conditions in which positive pressure ventilation must be avoided, such as bronchopleural fistula.

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