title: [Successful double-lumen tube intubation with the Pentax-AWS Airwayscope and a tracheal tube introducer in the lateral position for a patient with a giant mediastinal tumor].
abstract: Anesthetic management of a patient with giant mediastinal tumors is challenging from the perspective of both cardiovascular and respiratory management. We report the successful use of the Pentax-AWS Airwayscope (AWS; Hoya, Japan) and a tracheal tube introducer in the left lateral position for a patient with a giant mediastinal tumor. An 18-year-old man weighing 62 kg was scheduled for resection of a giant mediastinal tumor. He suffered from slight dyspnea in the supine position, and slept in the left lateral position. Preoperative chest X-P and computed tomography revealed compression of the left bronchus, heart and aorta. To avoid cardiac and respiratory collapse, anesthesia was induced in the left lateral position without a muscle relaxant. The patient was administered fentanyl 200 microg and propofol 150 mg; mask ventilation with the two-hand technique in the lateral position was successful. Subsequently, the AWS was inserted into his mouth and a 10 Fr tracheal tube introducer was placed in the trachea under the guidance of the AWS monitor. The patient was then intubated with a 35 Fr right-sided double-lumen tracheal tube under the guidance of the tracheal tube introducer. The head of the double-lumen tube was placed in the right bronchus under the guidance of a bronchofiberscope. Following tracheal tube placement, posture was shifted from the left lateral position to supine position without affecting vital signs. After median sternotomy, a muscle relaxant was administered for immobilization.
authors: Kenta
authors: K
authors: Nakao
authors: Nobuyasu
authors: N
authors: Komasawa
authors: Yosuke
authors: Y
authors: Kuzukawa
authors: Yasutaka
authors: Y
authors: Fujitate
authors: Toshiaki
authors: T
authors: Minami
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General; D005283:Fentanyl; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery*; D056888:Patient Positioning
chemical_list: D005283:Fentanyl