Thoracic epidural anesthesia with bupivacaine 0.25% does not impair ventilatory mechanics and inspiratory respiratory muscle strength in severely limited chronic obstructive pulmonary disease patients. Thus, thoracic epidural anesthesia can be used safely in patients with end-stage chronic obstructive pulmonary disease.

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Abstractafter the operation but was significantly reduced six months later. Pdi was inBackground -Lung volume reduction (LVR) has recently been used to treat creased three and six months after surgery.Conclusions -Ventilatory mechanics imsevere emphysema. About 25% of the volume of each lung is removed with this proved immediately after LVR, probably by decompression of lung tissue and relief method. Little is known about the mechanism of functional improvement so a of thoracic distension. An improvement Results -Mean forced expiratory volume one second (FEV 1 ) of 100% has been observed in one second (FEV 1 ) was 23 (3.6)% pre-in patients with favourable anatomical con-

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