title: [Dexmedetomidine is a useful concomitant anesthetic agent for perioperative management during tracheobronchial Dumon stent surgery].
abstract: We treated 2 patients, 1 undergoing placement and 1 removal of a tracheobronchial Dumon stent, both of whom required preservation of spontaneous breathing during the perioperative period to avoid life-threatening hypoxemia, with dexmedetomidine (DEX) as an anesthetic adjunct. In both cases, anesthesia was induced with 6 microg x kg(-1) x hr(-1) of DEX for 10 minutes and then maintained at 0.4-0.8 microg x kg(-1) x hr(-1), along with a target controlled infusion of propofol combined with intermittent administrations of low-dose fentanyl. Muscle relaxants were avoided and spontaneous breathing was preserved throughout the surgical procedures. The airway was secured using a rigid bronchoscope specific for a Dumon stent procedure. No rescue device, such as high frequency jet ventilation or a percutaneous cardiopulmonary support system, was needed. The perioperative courses were uneventful without any pulmonary or cardiovascular complications. DEX has potent sedative, amnesic, and analgesic properties with a low respiratory depressant effect. Therefore, it is considered useful as a concomitant anesthetic agent for perioperative management of patients who require preservation of spontaneous breathing.
authors.affiliation: Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima 734-8551.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kuroda
authors.forename: Shinji
authors.initials: S
authors.lastname: Kusunoki
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Osafumi
authors.initials: O
authors.lastname: Yuge
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D001980:Bronchi / Q000601:surgery*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014132:Trachea / Q000601:surgery*
chemical_list: D020927:Dexmedetomidine