Abstract:

A forty two year old male, a chronic smoker, was posted for lumbar discectomy at L3-4 level. General anaesthesia was administered and was maintained with isoflurane and nitrous oxide with oxygen. On turning the patient to prone position, the patient developed hypoxaemia. Air entry was reduced on the left lung field along with a rise in peak inspiratory pressure. CT scan of the thorax showed left sided pneumothorax, pneumomediastinum and subcutaneous emphysema. A chest tube thoracostomy was done and the patient made an uneventful recovery. We recommend that pneumothorax should be considered a possibility in any patient who has unexplained hypoxaemia during general anaesthesia and exercise caution while using nitrous oxide in chronic smokers.

Keywords: Pneumothorax, hypoxaemia, smoker.