PDF(Pubmed)
Abstract：
BACKGROUND: Mediastinal tumors pose a challenging respiratory and circulatory management during anesthesia procedures, there is a risk of circulatory collapse or complete airway obstruction, which in severe cases can lead to cardiac arrest. We reported a case of anesthetic management using a bronchial blocker placed outside the tracheal tube. In this case report, the patient\'s trachea was so severely compressed that the airway was extremely narrow, only 4 mm at its narrowest point. By reporting the anesthetic management of this patient, we intend to provide an unusual approach for airway management.
METHODS: A 52-year-old male patient was admitted to the hospital due to cough and expectoration for one year. Additionally, the patient experienced chest tightness and asthma after physical activity. The enhanced computed tomography revealed there existed an irregular soft tissue mass in the right upper mediastinum, which significantly compressed the trachea and esophagus. The results of the mediastinal puncture pathology showed the presence of mesenchymal tumors. According to the results above, the patient was diagnosed with a mediastinal tumor and scheduled to undergo tumor resection under general anesthesia. We used a bronchial occluder outside the tracheal tube for general anesthesia. After surgery, the patient received thorough treatment and was subsequently discharged from the hospital.
CONCLUSIONS: In patients with severe airway compression from a mediastinal tumor airway compression, positioning a bronchial occluder externally to the tracheal tube is an effective method of airway management. However, we still need more clinical practice to help the process become more standardized.
METHODS: A 52-year-old male patient was admitted to the hospital due to cough and expectoration for one year. Additionally, the patient experienced chest tightness and asthma after physical activity. The enhanced computed tomography revealed there existed an irregular soft tissue mass in the right upper mediastinum, which significantly compressed the trachea and esophagus. The results of the mediastinal puncture pathology showed the presence of mesenchymal tumors. According to the results above, the patient was diagnosed with a mediastinal tumor and scheduled to undergo tumor resection under general anesthesia. We used a bronchial occluder outside the tracheal tube for general anesthesia. After surgery, the patient received thorough treatment and was subsequently discharged from the hospital.
CONCLUSIONS: In patients with severe airway compression from a mediastinal tumor airway compression, positioning a bronchial occluder externally to the tracheal tube is an effective method of airway management. However, we still need more clinical practice to help the process become more standardized.
摘要：
背景：纵隔肿瘤在麻醉过程中具有挑战性的呼吸和循环管理，存在循环衰竭或完全气道阻塞的风险，严重时会导致心脏骤停.我们报告了一例使用放置在气管导管外的支气管阻滞剂进行麻醉管理的病例。在这个案例报告中,病人的气管被严重压迫，气道非常狭窄，最窄点只有4毫米。通过报告这名患者的麻醉管理，我们打算为气道管理提供一种不同寻常的方法.
方法：一名52岁男性患者因咳嗽咳痰1年入院。此外,患者在体力活动后出现胸闷和哮喘。增强的计算机断层扫描显示右上纵隔存在不规则的软组织肿块，显著压缩了气管和食道。纵隔穿刺病理成果显示存在间充质肿瘤。根据上述结果,患者被诊断为纵隔肿瘤，并计划在全身麻醉下进行肿瘤切除术。我们使用气管导管外的支气管封堵器进行全身麻醉。手术后,患者接受了彻底治疗，随后出院。
结论：纵隔肿瘤气道压迫导致严重气道压迫的患者，将支气管封堵器置于气管导管外部是一种有效的气道管理方法。然而,我们仍然需要更多的临床实践来帮助该过程变得更加标准化。
方法：一名52岁男性患者因咳嗽咳痰1年入院。此外,患者在体力活动后出现胸闷和哮喘。增强的计算机断层扫描显示右上纵隔存在不规则的软组织肿块，显著压缩了气管和食道。纵隔穿刺病理成果显示存在间充质肿瘤。根据上述结果,患者被诊断为纵隔肿瘤，并计划在全身麻醉下进行肿瘤切除术。我们使用气管导管外的支气管封堵器进行全身麻醉。手术后,患者接受了彻底治疗，随后出院。
结论：纵隔肿瘤气道压迫导致严重气道压迫的患者，将支气管封堵器置于气管导管外部是一种有效的气道管理方法。然而,我们仍然需要更多的临床实践来帮助该过程变得更加标准化。
