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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.

DOI:10.21037/jtd.2019.11.70
PMID:32030251
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6988036/
Abstract

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.

摘要

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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引用本文的文献

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J Cardiothorac Surg. 2024 Jul 26;19(1):468. doi: 10.1186/s13019-024-02949-8.
2
Using ketamine in a patient with a near-occlusion tracheal tumor undergoing tracheal resection and reconstruction: A case report.在一名患有接近闭塞性气管肿瘤的患者行气管切除重建术中使用氯胺酮:一例报告
World J Clin Cases. 2022 Aug 16;10(23):8417-8421. doi: 10.12998/wjcc.v10.i23.8417.
3
The strategy of non-intubated spontaneous ventilation anesthesia for upper tracheal surgery: a retrospective case series study.上气管手术非插管自主通气麻醉策略:一项回顾性病例系列研究
Transl Lung Cancer Res. 2022 May;11(5):880-889. doi: 10.21037/tlcr-22-302.
4
Airway management and anesthesia for airway surgery: a narrative review.气道手术的气道管理与麻醉:一篇叙述性综述。
Transl Lung Cancer Res. 2021 Dec;10(12):4631-4642. doi: 10.21037/tlcr-21-917.

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Nonintubated uniportal thoracoscopic wedge resection for early lung cancer.非插管单孔胸腔镜下早期肺癌楔形切除术
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Airway Management by Laryngeal Mask Airways for Cervical Tracheal Resection and Reconstruction: A Single-Center Retrospective Analysis.经喉罩气道行颈段气管切除与重建的气道管理:单中心回顾性分析。
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Chin J Cancer Res. 2015 Apr;27(2):197-202. doi: 10.3978/j.issn.1000-9604.2015.03.01.
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Nonintubated video-assisted thoracoscopic surgery under epidural anesthesia compared with conventional anesthetic option: a randomized control study.硬膜外麻醉下非插管电视辅助胸腔镜手术与传统麻醉方式的比较:一项随机对照研究
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Benign stenosis of the trachea.良性气管狭窄。
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Anesthesia for tracheal resection and reconstruction.气管切除与重建的麻醉
Anesthesiol Clin. 2012 Dec;30(4):709-30. doi: 10.1016/j.anclin.2012.08.012.
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Anesthesia with nontracheal intubation in thoracic surgery.非气管插管麻醉用于胸外科手术。
J Thorac Dis. 2012 Apr 1;4(2):126-30. doi: 10.3978/j.issn.2072-1439.2012.03.10.
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Impact of awake videothoracoscopic surgery on postoperative lymphocyte responses.清醒电视辅助胸腔镜手术对术后淋巴细胞反应的影响。
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