Sinha Renu, Trikha Anjan, Subramanian Rajkumar
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Saudi J Anaesth. 2017 Oct-Dec;11(4):490-493. doi: 10.4103/1658-354X.215427.
A 15-year-old boy, weighing 45 kg, 160 cm height with large anterior mediastinal mass and significant tracheal narrowing was scheduled for thoracotomy and excision of the mass. He had a history of progressive dyspnea, inability to lie supine, and a right upper hemithorax mass 13 cm × 13 cm × 11 cm as evident on a computerized tomography with significant compression of the trachea and right main stem bronchus. Inhalational induction was carried out using sevoflurane with 100% oxygen. After achieving adequate depth of anesthesia with the maintenance of spontaneous respiration with oxygen and sevoflurane (minimum alveolar concentration 1.7), left principal bronchus was intubated under fiber-optic bronchoscopy, with 5 mm cuffed microlaryngeal surgery tube. Excellent lung isolation was achieved. Selection of endotracheal tube for lung isolation and endobronchial intubation in the presence of significant tracheal narrowing are discussed.
一名15岁男孩，体重45千克，身高160厘米，患有巨大前纵隔肿块且气管明显狭窄，计划行开胸手术并切除肿块。他有进行性呼吸困难、无法仰卧的病史，计算机断层扫描显示右上半胸有一个13厘米×13厘米×11厘米的肿块，气管和右主支气管明显受压。采用七氟醚和100%氧气进行吸入诱导。在通过氧气和七氟醚维持自主呼吸达到足够麻醉深度（最低肺泡浓度1.7）后，在纤维支气管镜引导下插入左主支气管，使用5毫米带套囊的微喉手术管。实现了良好的肺隔离。讨论了在气管明显狭窄的情况下用于肺隔离和支气管内插管的气管导管选择。
