Anesthetic management in tracheoplasty surgery in a patient with tracheal stenosis due to prolonged intubation

Anesthetic management in tracheoplasty surgery in a patient with tracheal stenosis due to prolonged intubation

Author: 
Dr. Ramiro Wilberth Mendoza López, Dr. Miguel Ángel Nieto Rodriguez and Dr. Luis Gerardo Motta Amezquita
Abstract: 

Introduction: Tracheal stenosis after prolonged intubation is a pathology that represents a challenge for the anesthesiologist. Within its management, it must guarantee a permeable airway, adequate oxygenation, hemodynamic stability, adequate extubation and postoperative care. The selection of the treatment depends on the clinical condition of the patient and the tracheal anatomy. Objectives: To show the anesthetic management used in a patient undergoing tracheoplasty. Clinical case: Patient with tracheal stenosis secondary to prolonged intubation with conservative management based on a cannula of montgomery for 6 months with poor response to treatment, restenosis upon removal from the same, so he underwent tracheoplasty. The pre-anesthesia assessment performed is described. The premedication and the anesthetic plan are also exposed, with special emphasis on the transoperative as well as the postoperative care of the patient. Conclusions: Tracheoplasty is a relatively rare surgery, but one of the most challenging for anesthesiologists. To anticipate the course of surgery and design a successful anesthetic plan, it is necessary to understand the cause and characteristics of the tracheal lesion as well as the preoperative evaluation of the patient with tracheal stenosis.

Paper No: 
1865