Near ideal anesthetic technique for tracheal stenting in central airway obstruction with dexmedetomidine-ketamine infusion: a case report
Técnica anestésica quase ideal do implante de stent traqueal na obstrução de via aérea central com infusão de cetaminadexmedetomidina: um relato de caso
Sakshi Thakore, Nishkarsh Gupta, Karan Madan, Sushma Bhatnagar
Abstract
Central airway obstruction presents as an emergency with dyspnea and stridor. Anesthetic management of rigid bronchoscopy-guided tracheal stenting is highly stimulating procedure requiring general anesthesia. But it may lead to life threatening airway obstruction and cardiovascular collapse after induction. Total intravenous anesthesia based on propofol-remifentanil is an optimal anesthetic technique, but remifentanil is not available in many countries. Although dexmedetomidine-ketamine has been used for procedural sedation, its use for rigid bronchoscopy in the setting of central airway obstruction has not been described in literature. We describe near ideal anesthetic technique for management of central airway obstruction using dexmedetomidine-ketamine combination.
Keywords
Resumo
JA obstrução das vias aéreas centrais se apresenta como uma emergência com dispneia e estridor. O manejo anestésico do implante de stent traqueal rígido guiado por broncoscopia é um procedimento altamente estimulante que requer anestesia geral. Mas pode levar à obstrução das vias aéreas com risco de vida e colapso cardiovascular após a indução. A anestesia intravenosa total baseada em propofol-remifentanil é uma técnica anestésica ideal, mas o remifentanil não está disponível em muitos países. Embora a dexmedetomidina-cetamina tenha sido usada para sedação durante o procedimento, seu uso para broncoscopia rígida no cenário de obstrução das vias aéreas centrais não foi descrito na literatura. Descrevemos uma técnica anestésica quase ideal para o tratamento da obstrução das vias aéreas centrais usando a combinação de dexmedetomidina-cetamina.
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References
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