One-lung anesthesia

One-lung anesthesia was performed first by Gale and Waters in 1932.' They devised a curved, singlelumen cuffed tube which could be passed blindly into either mainstem bronchus.2 This accomplishment spurred the evolution of a variety of endobronchial tubes for one-lung anesthesia over the following years. One-lung anesthesia has been utilized for thoracic surgery for several decades. The lateral position is used most frequently, with the dependent or ventilated lung down. To enhance surgical exposure, a double-lumen endobronchial tube is inserted to allow the upper nondependent lung to be collapsed. Over the years, other indications have arisen for one-lung anesthesia that also have called for improvements in the technique. Today, nurse anesthetists must be aware of the indications for onelung anesthesia, the variety of endobronchial tubes available, methodology and basic pathophysiology, as well as possible complications and their management.