Takechi Kenichi, Sanki Yoko, Abe Kei, Shimizu Ichiro
Department of Anesthesia, Matsuyama Red Cross Hospital, 1 Bunkyocho, Matsuyama City, Ehime, Japan.
JA Clin Rep. 2022 Mar 17;8(1):22. doi: 10.1186/s40981-022-00513-8.
One-lung ventilation is a standard technique for thoracic anesthesia. Usually, one-lung ventilation requires a large-bore tracheal tube. Therefore, in patients with vocal cord morbidity, it is challenging to achieve one-lung ventilation while preventing the damage of vocal cord lesions.
A 77-year-old man was diagnosed with vocal cord cancer and lung tumor. One-lung ventilation with a combination of a laryngeal mask airway and bronchial blocker was planned to avoid unexpected vocal cord injury. After securing the airway with a laryngeal mask airway, a bronchial blocker was placed under fiberscope guidance. The bronchial blocker passed through a position far enough from the vocal cord lesion. The bronchial blocker provided a clear view of the operative field. The patient's perioperative course was uneventful.
When one-lung ventilation is required for patients with vocal cord lesions, a combination of a laryngeal mask airway and bronchial blocker is considered a good option.
单肺通气是胸段麻醉的一项标准技术。通常,单肺通气需要一根大口径气管导管。因此,对于有声带病变的患者,在防止声带病变受损的同时实现单肺通气具有挑战性。
一名77岁男性被诊断为声带癌和肺部肿瘤。计划采用喉罩气道和支气管封堵器联合进行单肺通气,以避免意外的声带损伤。在使用喉罩气道确保气道安全后,在纤维支气管镜引导下放置支气管封堵器。支气管封堵器通过了离声带病变足够远 的位置。支气管封堵器提供了清晰的手术视野。患者围手术期过程顺利。
对于有声带病变的患者需要进行单肺通气时,喉罩气道和支气管封堵器联合使用被认为是一个不错的选择。