Anesthetic management for bronchoscopy and debulking of obstructing intratracheal tumor

Abstract

Primary tracheal tumors comprise a rare group of benign and malignant tumors. Bronchoscopy is required for diagnosis and staging of tracheal neoplasms as well as debulking of the tumor. The management of anesthesia for rigid bronchoscopy in a patient with tracheal neoplasm presents with many challenges to the anesthetist. We present anesthetic management of an 18-year-old female who presented with orthopnea. Computed tomography scan of the thorax revealed a polypoidal lesion in the trachea proximal to carina and consolidation in the right middle lobe. The patient was scheduled for rigid bronchoscopy and debulking of the tumor. Case was successfully managed by providing positive pressure ventilation and oxygenation during rigid bronchoscopy using manual ventilation through the side port of the rigid bronchoscope. The procedure was uneventful, and patient improved symptomatically in the immediate postoperative period. The successful management of this case demonstrates the airway management in a patient with tracheal tumor for rigid bronchoscopy.

Recovery process and determinants of adverse event occurrence in bronchoscopic procedures performed under general anaesthesia

“…In our setting, patients were ventilated in controlled mode manually via side port of rigid bronchoscope. Manual bag ventilation helps eliminating the risk of circuit leak which particularly may cause trouble if neuromuscular blockage was administered . Pitfalls of this method can be listed as fatigue of the operator, lack of control of oxygenation at high flow rates and inappropriate delivery of inhalational agents if applicable …”

Interventional endoscopy for tracheal and bronchial tumors

“…Эндоскопические вмешательства позволяют в кратчайшие сроки восстановить и поддержать проходимость трахеи и бронхов. Но они относятся к категории сложных, поскольку связаны с высоким риском развития асфиксии при удалении опухоли, особенностями проведения анестезиологического пособия и выполняются в специализированных отделениях [3,[5][6][7][8][9][10].…”