Smith Clarissa B, Pitts Lucas, Postigo Maykol
The University of Kansas Health System, Department of Internal Medicine, Mailstop 1022 3901 Rainbow Boulevard, Kansas City, KS, 66160, United States.
The University of Kansas Health System, Division of Pulmonary, Critical Care, and Sleep Medicine, United States.
Heliyon. 2023 Jul 27;9(8):e18678. doi: 10.1016/j.heliyon.2023.e18678. eCollection 2023 Aug.
Rigid bronchoscopy is a common procedure for central airway obstructions (CAO). Many patients with advanced lesions causing CAO have tenuous, positionally dependent respiratory status which requires additional procedural considerations. This case report describes a 57-year-old man with high grade epithelioid angiosarcoma of the right lung and pleura who underwent placement of a tracheal stent by rigid bronchoscopy in the novel procedural conditions of right lateral decubitus, semi-sitting position with dexmedetomidine, midazolam, and propofol for moderate sedation. Dexmedetomidine, which is currently in use for flexible bronchoscopy due to its analgesic, anxiolytic, and antisialogogue properties performed ideally and should be further evaluated for this indication.
硬质支气管镜检查是治疗中央气道阻塞（CAO）的常用方法。许多因晚期病变导致CAO的患者呼吸状态脆弱且依赖体位，这需要在操作过程中加以额外考虑。本病例报告描述了一名57岁男性，患有右肺和胸膜的高级别上皮样血管肉瘤，在右侧卧位、半坐位并使用右美托咪定、咪达唑仑和丙泊酚进行中度镇静的新操作条件下，通过硬质支气管镜放置了气管支架。右美托咪定因其具有镇痛、抗焦虑和抑制唾液分泌的特性，目前已用于可弯曲支气管镜检查，其表现理想，应针对该适应症进行进一步评估。
