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[严重上气道梗阻患者行气管肿瘤二氧化碳激光切除术的麻醉管理]

[Anesthetic management for a patient with severely obstructed upper airway undergoing CO2 laser resection of the tracheal tumor].

作者信息

Koura Maki, Arai Tamie, Itou Nobuo, Toda Masaya, Murakami Satoshi, Hoka Sumio

机构信息

Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara 228-8555.

出版信息

Masui. 2006 Apr;55(4):441-4.

Abstract

A 76-year-old woman was scheduled to undergo a laser resection of the tracheal tumor which severely obstructed the upper airway. She had a past history of thoracic aortic aneurysm resection and myocardial infarction. After spraying the patient's oral cavity with 8% lidocaine, a laryngeal mask airway was inserted under spontaneous respiration. Tumor resection was successfully performed using CO2 laser through the laryngeal mask airway with the aid of low dose fentanyl under spontaneous respiration. Maintaining FIO2 at 0.5 could prevent hypoxemia. Although mild edema was observed in the larynx at the completion of the surgery, the patient achieved remarkable improvement in her breathing status. Consequently, she was able to undergo radiotherapy on the 5th postoperative day. This effectively reduced the tumor volume.

摘要

一名76岁女性计划接受气管肿瘤激光切除术,该肿瘤严重阻塞上呼吸道。她有胸主动脉瘤切除术和心肌梗死病史。在给患者口腔喷洒8%利多卡因后,于自主呼吸下插入喉罩气道。在自主呼吸下,借助低剂量芬太尼,通过喉罩气道使用二氧化碳激光成功进行了肿瘤切除。将吸入氧浓度维持在0.5可预防低氧血症。虽然手术结束时观察到喉部有轻度水肿,但患者的呼吸状况有显著改善。因此,她能够在术后第5天接受放疗。这有效地缩小了肿瘤体积。

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