Arime Hayato, Asai Takashi, Fujishiro Asuka, Saito Tomoyuki
Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
JA Clin Rep. 2024 Nov 28;10(1):73. doi: 10.1186/s40981-024-00757-6.
Anesthetic management of a patient with multiple giant bullae is generally difficult due to an increased risk of respiratory complications, and there is no consensus regarding safe extubation methods. We report a case of an effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae, in whom a double-lumen bronchial tube was being used during anesthesia.
A 52-year-old man with multiple giant bullae underwent video-assisted pulmonary resections, while the ventilation was controlled via a double-lumen bronchial tube. After successful thoracoscopic surgery, an i-gel™ was inserted while the double-lumen tube was still in place, and the double-lumen tube was subsequently removed under deep anesthesia. The i-gel™ was removed without complications after the patient had become able to respond to verbal command.
We believe that this method would minimize the risk of trauma to the respiratory system during emergence from anesthesia in patients with multiple giant bullae.
由于呼吸并发症风险增加,对患有多个巨大肺大疱的患者进行麻醉管理通常很困难,并且关于安全拔管方法尚无共识。我们报告一例在麻醉苏醒期有效使用声门上气道(i-gel™)的病例,该患者患有多个巨大肺大疱,麻醉期间使用双腔支气管导管。
一名患有多个巨大肺大疱的52岁男性接受了电视辅助肺切除术,同时通过双腔支气管导管控制通气。胸腔镜手术成功后,在双腔导管仍在位的情况下插入i-gel™,随后在深度麻醉下拔除双腔导管。患者能够对言语指令做出反应后,i-gel™顺利拔除,未出现并发症。
我们认为这种方法将使患有多个巨大肺大疱的患者在麻醉苏醒期呼吸系统受创伤的风险降至最低。