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气管支架食管穿透患者的麻醉管理:一例报告

Anesthetic management of a patient with esophageal penetration of a tracheal stent: a case report.

作者信息

Hori Yoko, Kishikawa Hiroaki, Sakamoto Atsuhiro

机构信息

Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603 Japan.

出版信息

JA Clin Rep. 2016;2(1):42. doi: 10.1186/s40981-016-0068-z. Epub 2016 Dec 3.

Abstract

BACKGROUND

Tracheal stent is a good way to maintain a patent airway in case of stenosis. Although anesthesia techniques for the placement of a stent in the trachea of patients with tracheal stenosis have been reported, the management of general anesthesia in patients with a tracheal stent is not well established.

CASE PRESENTATION

We report the anesthetic management in the patient with a partly fractured tracheal stent. A 65-year-old man with colon cancer was scheduled for colectomy under general anesthesia. Eight years ago, a tracheal stent was placed because of lung cancer. Preoperative evaluation revealed that a part of the tracheal stent had penetrated the esophagus. We induced general-epidural anesthesia via spontaneous breathing through a laryngeal mask airway to avoid mediastinal emphysema caused by positive pressure ventilation. The patient has been followed up for 2 years without any respiratory complications.

CONCLUSION

General anesthesia can be safely induced under spontaneous ventilation through a laryngeal mask airway in a patient with a fractured tracheal stent.

摘要

背景

气管支架是在气管狭窄时维持气道通畅的一种有效方法。虽然已有关于气管狭窄患者气管内支架置入的麻醉技术报道,但气管支架患者的全身麻醉管理尚未完全确立。

病例报告

我们报告了一例气管支架部分断裂患者的麻醉管理情况。一名65岁的结肠癌男性患者计划在全身麻醉下行结肠切除术。八年前,该患者因肺癌置入了气管支架。术前评估发现气管支架的一部分已穿透食管。我们通过喉罩气道自主呼吸诱导全身 - 硬膜外麻醉,以避免正压通气引起的纵隔气肿。该患者已随访2年,无任何呼吸并发症。

结论

对于气管支架断裂的患者,可通过喉罩气道在自主通气下安全诱导全身麻醉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efc5/5813763/07f1c5359007/40981_2016_68_Fig1_HTML.jpg

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