[One-lung ventilation using dexmedetomidine in an emphysema patient with pneumothorax due to metastatic lung cancer].

Abstract We report a case of double-lumen tube intubation and intraoperative one-lung ventilation under spontaneous breathing with continuous dexmedetomidine administration. A 61-year-old man developed pneumothorax due to multiple metastatic cancer, had multiple bilateral bullae, and underwent bullae resection under general anesthesia. An epidural catheter was placed at T8-9. Under dexmedetomidine sedation and regional anesthesia with lidocaine, a double-lumen tube was inserted with a Macintosh laryngoscope. The patient was under one-lung ventilation with spontaneous breathing during the operation. There were no complications from one-lung ventilation and the patient was extubated in the operating room. One-lung ventilation, which preserves spontaneous breathing, under dexmedetomidine sedation is considered effective for preventing barotrauma in patients with multiple metastatic cancer.