| Anesthesia for Cervical Trachesl Reconstruction . |
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Young Sook Kim, Hung Kun Oh |
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Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
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A 27 year-old male patient, who had cervical tracheal stenosis due to accidental inhalation of zinc dichloride gas, underwent tracheal reconstruction (tracheal resection and end to end anastomosis). Preoperatively, a special radiologic study (tracheography), pulmonary function tests and arterial blood gas analysis were performed for accurate diagnosis (to determine the location, degree and extent of the stricture) and to detect any associated abnormalities in the lung-function. Atropine and diazepam were given for premedication. After intramuscular injection of ketamine and succinylcholine, orotracheal intubation was done above the lesion, and N2O and halothane were added for maintenance of anesthesia. Respiration was assisted or controlled when necessary with gallamine. The lesion was approached through an anterior transverse cervical incision. The trachea. was dissected clear and transected distal to the lesion. The distal tracheal segment was then intubated through the operating field with a sterile cuffed endotracheal tube (the 2nd tube). This was connected to the anesthetic machine.
After resection of the lesion and anastomosis. of the posterior tracheal wall, the 2nd tube was removed and orotracheal tube was pushed into the distal trachea. After complete anastomosis the orotracheal tube was placed above the suture line.Continuous arterial blood gas analysis during and after anesthesia was helpful for evaluation of the state of arterial blood oxygenation and ventilation. |
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