用于颈椎气管切除与重建的自主呼吸麻醉
Spontaneous breathing anesthesia for cervical tracheal resection and reconstruction.
作者信息
Zhou Yanran, Liu Hui, Wu Xi, Li Shuben, Liang Lixia, Dong Qinglong
机构信息
Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
出版信息
J Thorac Dis. 2019 Dec;11(12):5336-5342. doi: 10.21037/jtd.2019.11.70.
BACKGROUND
Spontaneous breathing anesthesia (SBA) may have advantages over general anesthesia for cervical tracheal resection and reconstruction (TRR), avoiding the difficulties and complication caused by endotracheal intubation and surgical cross-field intubation. This prospective study evaluates SBA for cervical TRR.
METHODS
Date was obtained from 35 patients who had cervical TRR under SBA from May 2015 to March 2019. Intravenous sedation and ultrasound-guided bilateral superficial cervical plexus block (CPB) were applied to maintain effective analgesia and sedation.
RESULTS
Thirty-two patients with tracheal tumors and 3 patients with post-intubation tracheal stenosis underwent TRR. After the airway was opened, 29 patients resumed stable spontaneous breathing, 1 patient needed high-frequency jet ventilation, and 1 patient needed anesthesia conversion for surgical reasons.
CONCLUSIONS
Spontaneous breathing anesthesia is feasible for the cervical TRR. It can be an alternative anesthetic technique for certain patients.
背景
对于颈椎气管切除重建术（TRR），自主呼吸麻醉（SBA）可能优于全身麻醉，可避免气管插管和手术跨野插管引起的困难及并发症。本前瞻性研究评估SBA用于颈椎TRR的效果。
方法
收集2015年5月至2019年3月期间35例行SBA下颈椎TRR患者的数据。采用静脉镇静和超声引导下双侧颈浅丛阻滞（CPB）以维持有效的镇痛和镇静。
结果
32例气管肿瘤患者和3例插管后气管狭窄患者接受了TRR。气道开放后，29例患者恢复稳定的自主呼吸，1例患者需要高频喷射通气，1例患者因手术原因需要更改麻醉方式。
结论
自主呼吸麻醉用于颈椎TRR是可行的。对于某些患者，它可以作为一种替代的麻醉技术。
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