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영남의대학술지 Vol.24_No.2 Suppl. P.S696-701, Dec. 2007

Case Report

전신마취 후 회복실에서 발견된 무기폐의 치료

Treatment of Atelectasis Dectected in the Recovery Room after General Anesthesia

황창재, 김흥대, 박대팔, 서일숙, 송선옥, 김세연, 지대림, 이덕희
영남대학교 의과대학 마취통증의학교실
책임저자:송선옥, 대구광역시 남구 대명동 317-1번지, 영남대학교 의과대학 마취통증의학교실
Tel: (053) 620-3353, Fax: (053) 626-5275
E-mail: sosong@med.yu.ac.kr

December 30, 2007


Atelectasis is a relatively common complication following surgery in anesthetized patient with respiratory symptoms, but rarely occur in normal healthy patient. Anesthesiologists must be wary to prevent atelectasis, because it may lead to hypoxia during and after the operation.
This case reports a healthy patient without previous respiratory symptoms who developed left lower lobar atelectasis after general anesthesia. Vigorous chest physiotherapy including intended coughing, deep breathing, chest percussion and vibration under postural change was effective. Therefore, vigorous chest physiotherapy is essential part of early treatment modalities for atelectasis in postoperative recovery room.

Key Words: Atelectasis, Chest physiotherapy, General anesthesia


1. 대한마취과학회 교과서편찬위원회, 마취과학, 서울, 군자출판사;2002(3):1343-69

2. Tokics L, Hedenstierna G, Svensson L, Brismar B, orsten Cederlund, Hans Lundquist T, et al. V/Q distribution and correlation to atelectasis in anesthetized paralyzed humans. J Appl Physiol 1996;81(4):1822-33.

3. Strandberg A, Tokics L, Brismar B, Lundquist H, Hedenstierna G. Constitutional factors promoting development of atelectasis during anesthesia. Acta Anaesthesiol Scand 1987;31: 21-4.

4. Gunnarsson L, Tokics L, Lundquist H, Brismar B, Strandberg A, Berg B, et al. Chronic obstructive pulmonary disease and anesthesia: formation of atelectasis and gas exchange impairment. Eur Respir J 1991;4:1106-16.

5. Rahn H, Farhi LE. Gaseous environment and atelectasis. Fed Proc 1963;22:1035-41.

6. Tokics L, Strandberg A, Brismar B, Lundquist H, Hedenstierna G. Computerized tomography of the chest and gas exchange measurements during ketamine anesthesia. Acta Anaesthesiol Scand 1987;31:684-92.

7. Hedenstierna G, Tokics L, Lundquist H, Andersson T, Strandberg A, Brismar B. Phrenic Nerve Stimulation during Halothane Anesthesia. Anesthesiology 1994; 80:751-60.

8. Oyarzun MJ, Iturriaga R, Donso P, Dussaubat N, Santos M, Schiapacasse ME. Factors affecting distribution of alveolar surfactant during resting ventilation. Am J Physiol(Lung Cell Mol Physiol) 1991;261(2pt1):L210-7.

9. Tokics L, Hedenstierna G, Strandberg A, Brismar B, Lundquist H. Lung collapse and gas exchange during general anesthesia: Effects of spontaneous breathing, muscle paralysis, and positive end-expiratory pressure. Anesthesiology 1987;66(2):157-67.

10. West JB. State of the art: Ventilation-perfusion relationships. Am Rev Respir Dis 1977;116(5): 919-43.

11. Rothen HU, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Re-expansion of atelectasis during general anesthesia: A computed tomo- graphy study. Br J Anaesth 1993;71(6):788-95.

12. Rothen HU, Neumann P, Berglund JE, Valtysson J, Magnusson A, Hedenstierna G. Dynamics of re-expansion of atelectasis during general anaesthesia. Br J Anaesth 1999;82(4):551-6.

13. Rothen HU, Sporre B, Engberg G, Wegenius G, Hogman M, Hedenstierna G. Influence of gas composition on recurrence of atelectasis after a reexpansion maneuver during general anesthesia. Anesthesiology 1995;82(4):832-42.

14. Reber A, Engberg G, Wegenius G, Hedenstierna G. Lung aeration. The effect of pre-oxygenation and hyperoxygenation during total intravenous anesthesia. Anesthesia 1996;51:733-7.

15. Iverson LI, Ecker RR, Fox HE, May IA. A comparative study of IPPB, the incentive spirometer, and blow bottles: The prevention of atelectasis following cardiac surgery. Ann Thorac Surg. 1978 Mar;25(3):197-200.

16. van der Schans CP. Forced expiratory manoeuvres to increase transport of bronchial mucus: A mechanistic approach. Monaldi Arch Chest Dis 1997;52:367-70.

17. Dean E. Effect of body position on pulmonary function. Phys Ther 1985;65(5):613-8.