PDF(Pubmed)
Abstract：
We report the case of a 53-year-old female who developed tracheobronchomalacia immediately following an uncomplicated robotic hysterectomy with bilateral salpingo-oophorectomy to treat postmenopausal bleeding. Induction of anesthesia was notable for moderately difficult intubation, managed with applied cricothyroid pressure and a small 6.5 endotracheal tube placement via GlideScope. The surgical course was uneventful. The patient remained intubated in the post-anesthesia care unit but was not providing end-tidal volumes. Attempts to replace the endotracheal tube with a larger tube were unsuccessful and the patient was temporarily unable to ventilate. Rapid troubleshooting discovered that a laryngeal mask airway (LMA) could sufficiently ventilate the patient. An otolaryngologist was able to perform direct bronchoscopy, which revealed more than 50% dynamic anterior-posterior collapse of the trachea and bronchi. The patient was subsequently awakened from anesthesia and monitored in the intensive care unit, ventilating with an LMA. After a couple of hours, it was determined that the patient\'s airway was protected, and the LMA was removed.
摘要：
我们报告了一例53岁的女性，该女性在进行无并发症的机器人子宫切除术和双侧附件卵巢切除术以治疗绝经后出血后立即出现气管支气管软化症。中度困难插管时，麻醉诱导明显，通过GlideScope施加环甲压力和小的6.5气管内导管放置来管理。手术过程顺利。患者仍在麻醉后护理单元中插管，但未提供潮气量。尝试用较大的导管替换气管导管失败，患者暂时无法通气。快速故障排除发现喉罩气道（LMA）可以为患者充分通气。一位耳鼻喉科医生能够进行直接支气管镜检查，显示气管和支气管的动态前后塌陷超过50％。病人随后被麻醉苏醒，并在重症监护室接受监测，用LMA通风。几个小时后，确定患者的气道受到保护，LMA被移除.
