National Heart Centre, 17 Third Hospital Avenue, Singapore 168752.
Singapore Med J. 2011 May;52(5):e100-1.
Patients with bronchopleural fistula present with specific airway management and ventilatory concerns, which makes the anaesthetic management of these patients challenging. Myasthenia gravis is another condition requiring specific anaesthetic management, with possible unpredictable delays in recovery. A combination of both these conditions in a patient makes management even more difficult. Our patient with myasthenia gravis underwent repair of the bronchopleural fistula, during which a multimodal approach to intraoperative and postoperative analgesia was adopted. Positive pressure ventilation was started only after we confirmed the isolation of the lung.
患有支气管胸膜瘘的患者存在特定的气道管理和通气问题，这使得这些患者的麻醉管理具有挑战性。重症肌无力是另一种需要特殊麻醉管理的疾病，可能会出现不可预测的恢复延迟。在患者中同时存在这两种情况会使管理更加困难。我们的重症肌无力患者接受了支气管胸膜瘘修复手术，在此期间采用了多模式方法来进行术中及术后镇痛。只有在确认肺隔离后，才开始正压通气。
