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Using ketamine in a patient with a near-occlusion tracheal tumor undergoing tracheal resection and reconstruction: A case report

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World Journal of Clinical Cases 2022年第23期10卷 8417-8421页

作者： Xiao-Han Xu Hui Gao Xing-Ming Chen Hao-Bo Ma Yu-Guang Huang Department of Anesthesiology Peking Union Medical College HospitalBeijing 100730China Department of Otolaryngology-Head and Neck Surgery Peking Union Medical College HospitalBeijing 100730China Department of Anesthesia Critical Care and Pain MedicineBeth Israel Deaconess Medical CenterBostonMA 02215United States

BACKGROUND Tracheal tumors may cause airway obstruction and pose a significant risk to ventilation and *** to its rarity,there is currently no established protocol or guideline for anesthetic management of resection of upper tracheal tumors,therefore individualized strategies are *** are limited number of reports regarding the anesthesthetic management of upper tracheal resection and reconstruction(TRR)in the *** successfully used intravenous ketamine to manage a patient with a near-occlusion upper tracheal tumor undergoing *** SUMMARY A 25-year-old female reported progressive dyspnea and *** showed an intratracheal tumor located one tracheal ring below the glottis,which occluded>90%of the tracheal *** patient was scheduled for *** the risk of complete airway collapse after the induction of general anesthesia,we decided to secure the airway with a tracheostomy with spontaneous *** surgeons needed to transect the trachea 1-2 cartilage rings below and above the tumor borders:a time-consuming *** and movement needed be minimized;thus,we added intravenous ketamine to local anesthetic *** tracheostomy,an endotracheal tube was placed into the distal trachea,and general anesthesia was *** surgeons resected four cartilage rings with the tumor attached and anastomosed the posterior tracheal *** performed a video-laryngoscopy to place a new endotracheal ***,the surgeons anastomosed the anterior tracheal *** patient was extubated *** Ketamine showed great advantages in the anesthesia of upper TRR by providing analgesia with minimal respiratory depression or airway collapse.

关键词： Ketamine near-occlusion Upper tracheal tumor Tracheal resection and reconstruction Tracheostomy Case report

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