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Korean Journal of Anesthesiology 2008;55(6):747-751.
DOI: https://doi.org/10.4097/kjae.2008.55.6.747   
Intravenous anesthesia using laryngeal mask airway without muscle relaxants during tracheostomy in a patient with quadriplegia: A case report.
Seung Hun Yeom, Sang Ho Jeong, Myung Hwa Ha, Nam Won Song
Department of Anesthesiology and Pain Medicine, Maryknoll Hospital, Busan, Korea. inature7@naver.com
Quadriplegia is a serious or complete loss of motor function of all four limbs that is commonly caused by spinal cord injuries secondary to damage to the cervical spine. In this situation, there is a higher risk of pneumonia due to paralysis of the respiratory muscles. Tracheostomy is preferred over endotracheal intubation for the effective elimination of sticky bronchial secretion. The safest technique for a tracheostomy is to carry it out under general anesthesia with endotracheal intubation. However, endotracheal intubation may be difficult and cause other complications in patients with laryngotracheal stenosis caused by repeated tracheostomy and a limitation of neck movement as a result of the fixation of the cervical vertebral bodies due to the cervical spine fracture. We report a case of a tracheostomy performed sucessfully under intravenous anesthesia using a laryngeal mask airway without muscle relaxants in a patient with quadriplegia caused by a cervical spine injury.
Key Words: intraveneous anesthesia; laryngeal mask airway; quadriplegia; tracheostomy


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