[Anesthetic management of laser surgery with bronchial stenting for a tracheal tumor].
Anesthetic management during surgery for a tracheal tumor is extremely difficult in terms of airway management. We managed a patient with a tracheal tumor who was successfully treated without complication. The trachea of a 66-year-old woman was narrowed by a tumor to one-third of its original diameter, for which Nd-YAG laser surgery with insertion of an intratracheal Dumon stent was performed. Anesthesia was maintained with neuroleptanalgesia using fentanyl and droperidol, supplemented with a TCI infusion of propofol under spontaneous breathing. High frequency jet ventilation (HFJV) was prepared for intraoperative poor oxygenation and/or ventilation. The patient was able to maintain a good respiratory condition throughout the operation without special respiratory support, including use of HFJV. We conclude that the maintenance of spontaneous breathing is essential for anesthetic management in the present case, while an intraoperative airway strategy based on the preoperative breathing condition of the patient is also important.
Tsuji
Mika
M
Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima 734-0037.
Hamada
Hiroshi
H
Kawamoto
Masashi
M
Yuge
Osafumi
O
D000368:Aged; D000758:Anesthesia; D005260:Female; D006801:Humans; D053685:Laser Therapy; D009458:Neuroleptanalgesia; D019990:Perioperative Care; D012119:Respiration; D015607:Stents; D014134:Tracheal Neoplasms / Q000628:therapy*; D016896:Treatment Outcome