Pérez-Carbonell A, Cordero-Escobar I, Company-Teuler R, Rey-Martínez B

Language: Spanish
References: 10
Page: 292-295
PDF size: 103.65 Kb.

ABSTRACT

Introduction: Idiopathic laryngotracheal stenosis is an uncommon and almost exclusively of women. Objective: To describe the anaesthetic management of a patient with idiopathic laryngotracheal stenosis was used i-gel mask, rocuronium and reversal with sugammadex. Case report: 67 year old female patient, ASA III was admitted to the General Hospital of Alicante, Spain by shortness of breath. In the pre-anesthesia visit Mallampatti III was found. Induction with propofol (TCI), fentanyl 2 µg and rocuronium 1 mg/kg (60 mg). The airway is addressed without incident with i-gel mask until it was opened. Was attached to a jet ventilator. Was monitored by pulse oximetry, capnography, heart rate, invasive blood pressure, electrocardiogram, cardiac output, stroke volume, bispectral index and neuromuscular function. Continuous infusion propofol and remifentanyl maintenance and rocuronium 0.5 mg/kg/h (TCI). The three-ring tracheal resection and reconstruction lasted 3 hours 30 minutes. Intraoperative neuromuscular function was maintained at T1. After the intervention was administered 2 mg/kg of sugammadex. The T₄/T₁ ratio was › 90%, at 39 seconds. Was extubated without complications. Progressed satisfactorily in 48 hours in the Postoperative Care Unit. Conclusions: You can use supraglottic devices and rocuronium in patients with idiopathic laryngeal stenosis, as continuous infusion achieves a stable basis of neuromuscular blocking blood easily reversed by sugammadex.

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