Anaesthetic Management of Tracheal Surgery Using the Laryngeal Mask Airway

Divatia, Jigeeshu Vasishtha; Sareen, R; Upadhye, S. M.; Sharma, Kailash S.; Shelgaonkar, J. R.

doi:10.1177/0310057x9402200112

Cited by 18 publications

(4 citation statements)

References 26 publications

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“…28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high-ow nasal oxygen. The median apnoea time was 19 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24) mins. Four patients experienced a transient episode of oxygen desaturation to a value between 85% and 90%.…”

Section: Resultsmentioning

confidence: 99%

Apnoeic Oxygenation with High‐Flow Oxygen for Tracheal Resection and Reconstruction Surgery

Lý¹,

Dinh²,

Trang³

et al. 2021

Preprint

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Background: Tracheal resection and reconstruction are the most effective treatment tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient's same airway. High‐flow oxygen has begun to be applied prolonging the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apnoeic conditions with high‐flow oxygen as the sole method of gas exchange during anastomosis construction. Methods: A prospective study was performed on 16 patients with tracheal stenosis, with ages ranging from 19 to 70, underwent tracheal resection and reconstruction from April 2019 to August 2020 in 108 Military Central Hospital. During the anastomosis phase using high flow oxygen of 35-40 L/min delivered across the open tracheal with an endotracheal tube (ETT) at the glottis in apnoeic conditions. Results: The mean (SD) apnoea time was 20.91 (2.53) mins. Mean (SD) time anastomosis was 22.9 (2.41) mins. The saturation of oxygen was stable during all procedures at 98-100%. Arterial blood gas analysis showed mean (SD) was hypercapnia and acidosis acute respiratory after 10 mins of apnoea and 20 mins apnoea respectively. However, after 15 mins of ventilation, the parameters are ultimately returned to normal. All 16 patients were extubated early and safely at the end of the operation. There were no complications, such as bleeding, hemothorax, pneumothorax, or barotrauma.Conclusion: High-flow oxygen across the open tracheal under apnoeic conditions can provide a satisfactory gas exchange to allow tubeless anesthesia for tracheal resection and reconstruction.

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Section: Resultsmentioning

confidence: 99%

Apnoeic Oxygenation with High‐Flow Oxygen for Tracheal Resection and Reconstruction Surgery

Lý¹,

Dinh²,

Trang³

et al. 2021

Preprint

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show abstract

“…J.V. Divatia et al [ 18 ], Byung Cheul Shin et al [ 19 ] have used the LMAP for airway management successful without any complications for surgery of a high tracheal tumor and high tracheal stenosis sited near the vocal cord, it is difficult to manage airway using a cuffed endotracheal tube. They found that the LMA has advantages when used in general anesthesia for tracheal surgery, especially with tumors situated just below the vocal cords.…”

Section: Discussionmentioning

confidence: 99%

Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery

Dinh

Trang

et al. 2022

BMC Anesthesiol

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Background Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient’s same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apneic conditions with high-flow oxygen as the sole method of gas exchange during anastomosis construction. Methods A prospective study was performed on 16 patients with tracheal stenosis, with ages ranging from 19 to 70, who underwent tracheal resection and reconstruction from April 2019 to August 2020 in 108 Military Central Hospital. During the anastomosis phase using high flow oxygen of 35–40 l.min-1 delivered across the open tracheal with an endotracheal tube (ETT) at the glottis in apnoeic conditions. Results The mean (SD) apnoea time was 20.91 (2.53) mins. Mean (SD) time anastomosis was 22.9 (2.41) mins. The saturation of oxygen was stable during all procedures at 98–100%. Arterial blood gas analysis showed mean (SD) was hypercapnia and acidosis acute respiratory after 10 mins of apnoea and 20 mins apnoea respectively. However, after 15 mins of ventilation, the parameters are ultimately returned to normal. All 16 patients were extubated early and safely at the end of the operation. There were no complications, such as bleeding, hemothorax, pneumothorax, or barotrauma. Conclusion High-flow oxygen across the open tracheal under apnoeic conditions can provide a satisfactory gas exchange to allow tubeless anesthesia for tracheal resection and reconstruction.

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“…Brimacombe et al 5 biopsied vocal cords in 10 patients through general LMA anesthesia using flexible bronchoscopy. Bronchoscopic laser surgery through the LMA has been described for lesions of the upper trachea within 3 cm of the vocal cords 6 and for airway palliation of an extensive lesion that involved the larynx, trachea, and bronchus 7 . Yamaguchi et al 8 used the Nd:YAG laser through LMA to treat a subglottic tumor.…”

Section: Discussionmentioning

confidence: 99%