[Anesthetic management of a patient in whom one-lung ventilation occurred due to an incorrectly positioned stent].
Stents are inserted for severe stenosis of the trachea owing to malignant tumors, but an incorrectly positioned stent can cause airway obstruction. Here, we report the anesthetic management of a patient undergoing removal of an incorrectly positioned stent. A 56-year-old man had a stent inserted in the trachea for stenosis caused by a tumor. One month later, he was scheduled for reinsertion of a stent for tracheal stenosis owing to growth of the tumor, but the stent was inserted in the left main bronchus interfering ventilation to the right lung. Therefore, removal of the stent under general anesthesia was scheduled. As the stent was to be removed from an incision in the cricoid, we had to maintain deep anesthesia to maintain immobility, keeping spontaneous respiration in case we could not ventilate during surgery. Since inhaled anesthetics are insufficient to maintain deep anesthesia, we anesthetized the patient with an intravenous anesthetic, sevoflurane and continuous propofol infusion. Propofol allows spontaneous respiration better than opioids. With this method we were able to anesthetize the patient maintaining spontaneous respiration and oxygenation with stable vital signs during surgery.
Horishita
Takafumi
T
Department of Anesthesiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu.
Minami
Kouichirou
K
Shiraishi
Munehiro
M
Terada
Tadanori
T
Sata
Takeyoshi
T
D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D006801:Humans; D008168:Lung / Q000502:physiology; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage; D000077149:Sevoflurane; D015607:Stents / Q000009:adverse effects*; D014135:Tracheal Stenosis / Q000628:therapy*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol