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Anaesthetic management of a patient with giant lung bulla who undergoes laparoscopic surgery deserves special considerations in view of the possible complications associated with the bulla. There may be acute enlargement or rupture of the bulla, necessitating emergency management. Precautionary measures which may be taken during anaesthesia include the avoidance of nitrous oxide, keeping low airway pressures during the surgery, immediate availability of chest drains in the anaesthetizing area and continuous monitoring including auscultation of the chest, observing airway pressures and arterial blood gas analysis. Avoidance of nitrous oxide, keeping low airway and intraabdominal pressures during the surgery are basic measures for a safe outcome in laparoscopic surgeries in patients with an underlying bulla. Apart from that, immediate availability of chest drains in the an - aesthetizing area and continuous monitoring including auscultation of the chest and arterial blood gas analysis should be carried out in order to urgently detect any adverse consequences during the surgery.
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