Department of onco-Anesthesiology, DRBRAIRCH, AIIMS, New Delhi.
Department of Pulmonary and critical care medicine, AIIMS, New Delhi.
Braz J Anesthesiol. 2021 Jul-Aug;71(4):447-450. doi: 10.1016/j.bjane.2021.03.019. Epub 2021 Apr 22.
Central airway obstruction presents as an emergency with dyspnea and stridor. Anesthetic management of rigid bronchoscopy-guided tracheal stenting is highly stimulating procedure requiring general anesthesia. But it may lead to life threatening airway obstruction and cardiovascular collapse after induction. Total intravenous anesthesia based on propofol-remifentanil is an optimal anesthetic technique, but remifentanil is not available in many countries. Although dexmedetomidine-ketamine has been used for procedural sedation, its use for rigid bronchoscopy in the setting of central airway obstruction has not been described in literature. We describe near ideal anesthetic technique for management of central airway obstruction using dexmedetomidine-ketamine combination.
中央气道阻塞表现为呼吸困难和喘鸣的紧急情况。刚性支气管镜引导下气管支架置入的麻醉管理是一项高度刺激的程序,需要全身麻醉。但在诱导后可能导致危及生命的气道阻塞和心血管崩溃。基于丙泊酚-瑞芬太尼的全静脉麻醉是一种最佳的麻醉技术,但许多国家都没有瑞芬太尼。虽然右美托咪定-氯胺酮已被用于程序镇静,但在中央气道阻塞的情况下,它在刚性支气管镜检查中的应用尚未在文献中描述。我们描述了使用右美托咪定-氯胺酮组合治疗中央气道阻塞的近乎理想的麻醉技术。