Ramsay Michael A E, Saha Devi, Hebeler Robert F
Department of Anesthesiology and Pain Management, Baylor University Medical Center, Dallas, TX 75246, USA.
J Clin Anesth. 2006 Sep;18(6):452-4. doi: 10.1016/j.jclinane.2006.02.004.
We present a case of respiratory distress in a morbidly obese woman, which was complicated by a severe tracheal stenosis of the third to sixth cartilage. She had a history of sleep apnea and could only breathe sitting upright. An anesthetic, technique using dexmedetomidine was selected because of its properties of anxiolysis and sedation, with lack of respiratory depression. No intraoperative or postoperative opioids were required. Dexmedetomidine in high doses offers another approach to managing the patient with a compromised airway. Opioids were avoided in this patient, who was at major risk of postoperative respiratory depression and sleep apnea.
我们报告一例病态肥胖女性的呼吸窘迫病例，该病例并发了第三至第六软骨严重气管狭窄。她有睡眠呼吸暂停病史，只能端坐呼吸。由于右美托咪定具有抗焦虑和镇静特性且无呼吸抑制作用，因此选择了使用右美托咪定的麻醉技术。术中及术后均无需使用阿片类药物。高剂量右美托咪定提供了另一种管理气道受损患者的方法。该患者有术后呼吸抑制和睡眠呼吸暂停的重大风险，故避免使用阿片类药物。
