Sato M, Honda O, Hiraga K
Department of Surgery and Department of Anesthesiology, National Cancer Center Hospital, Tokyo 104-0045.
Masui. 2001 Nov;50(11):1236-8.
An 80-year old female underwent subtotal esophagectomy with neck lymphnode dissection for esophageal cancer. The tracheal intubation was done repeatedly. Anesthesia was maintained with O2-N2O-isoflurane. No complications were observed during the operation. About thirty minutes after tracheal extubation, she developed airway obstruction with tracheal tug and stridor. Severe laryngeal edema was found by bronchofiberscopy. Percutaneous minitracheostomy was performed under ventilation support by laryngeal mask airway. Seven days later, bronchoscopy examination revealed that the laryngeal edema had disappeared. It should be kept in mind that severe laryngeal edema could develop immediately after extubation.
一位80岁女性因食管癌接受了食管次全切除术并颈部淋巴结清扫术。气管插管反复进行。采用氧气-氧化亚氮-异氟烷维持麻醉。术中未观察到并发症。气管拔管后约30分钟,她出现了伴有气管牵拉和喘鸣的气道梗阻。经纤维支气管镜检查发现严重的喉水肿。在喉罩气道通气支持下进行了经皮微创气管切开术。7天后,支气管镜检查显示喉水肿已消失。应牢记,拔管后可能立即发生严重的喉水肿。