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September 5, 1966

Choice of Anesthetic Technique in Patients With Acute Pulmonary Disease

JAMA. 1966;197(10):789-790. doi:10.1001/jama.1966.03110100097021

A 75-year-old woman was admitted to the hospital two days following an intertrochanteric fracture of her left hip. She had been hospitalized in another hospital for the two-day period.

Past history revealed an episode of pneumonia of the middle lobe of the right lung four years prior to admission and pneumonia of the lower lobe of the right lung six months prior to admission. She had had asthma for several years. She had daily a productive cough producing thick tenacious sputum, quantity unknown; she denied having dyspnea. Physical examination revealed a reasonably healthy old woman. There were rales throughout her left lung field, and chest x-ray films revealed a marked tracheal deviation and apparent near-total collapse of the left lung (Figure). On the basis of traditional concepts that inhalation anesthesia may be injurious to the lungs and not tolerated well by patients with lung disease, regional anesthesia was strongly recommended