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Anaesthesia for tracheal resection. Modified use of the carden tube

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Summary

Surgical procedures involving sharing of the airway between the anaesthetist and surgeon, such as bronchoscopy, microlaryngeal surgery and tracheal resection impose special problems on the anaesthetist. The surgeon requires unre stricted surgical access, whereas the anaesthetist must ensure adequate and safe pulmonary ventilation and anaesthesia.

This case report describes a two stage technique for management of the airway and ventilation during tracheal resection for stenosis. Initially a modified Carden tube with a ventilating injector was used through a tracheostomy stoma and subsequently an orotracheal tube was substituted. Anaesthesia was maintained entirely by the intravenous route. The surgical access was unrestricted and there was no pulmonary contamination.

Résumé

On rapporte ici un cas de résection de sténose trachée sous anesthésie intraveineuse (curare et alfathésin). La perméabilité et ľétanchéité des voies aériennes ont été assurées dans un premier temps au moyen ďun tube de Carden à ballonnet introduit dans ľouverture de trachéostomie, la ventilation étant contrölée par une technique à injection intermittente de gaz; un cathéter relié à une succion continue et placé dans la lumière du tube de Carden assurait un drainage continu en plus de recueillir les gaz expirés. Après résection de la partie sténosée et resuture bout à bout de la portion trachéale postérieure, on a substitué un tube orotrachéal au tube de Carden, ce tube étant descendu juste au-dessus de la carène de façon à pouvoir gonfler le ballonnet et compléter la suture de la trachée sous ventilation contrölée conventionnelle. Cette technique assure une protection efficace des voies aériennes tout en facilitant la chirurgie.

References

  1. 1.

    Carden, E. &Crutchfield, W. Anaesthesia for microsurgery of the larynx. Can. Anaes. Soc. J.,20: 378 (1973).

  2. 2.

    Sanders, R.D. Two ventilating attachments for bronchoscopes. Delaware Medical Journal,39: 170 (1967).

  3. 3.

    Spoerel, W.E. Ventilation through an open bronchoscope. Can. Anaes. Soc. J.,16: 61 (1969).

  4. 4.

    Savege,T.M., Ramsay,M.A.E., Curran, J.P.J., Cotter, J., Walling, P.T., &Simpson, B.R. Intravenous anaesthesia by infusion. Anaesthesia,30: 757 (1975).

  5. 5.

    Jago, R.H. &Restall, J. Total intravenous anaesthesia. A technique based on alphaxalone/alphadolone and pentazocine. Anaesthesia,32: 904 (1977).

  6. 6.

    Geffin, B., Bland, J., &Grillo, H.C. Anaesthetic management of tracheal resection and reconstruction. Anaesthesia and Analgesia Current Researches,45: 884 (1969).

  7. 7.

    Kamvyssi-Dea., S., Kritikou, P., Exarhos, N., &Skalkeas, G. Anaesthetic management of reconstruction of lower portion of trachea. Brit. Jour. Anaes.29: 760 (1975).

  8. 8.

    Heifetz, H. Management of anaesthesia during tracheal resection. Anaesthesia,29: 760 (1974).

  9. 9.

    Wandless, J.G. Management of anaesthesia during tracheal resection. Anaesthesia,32: 389 (1977).

  10. 10.

    Ellis, R.H. &Hinds, C.J. Management of anaesthesia during tracheal resection. Anaesthesia,32: 389 (1977).

  11. 11.

    English, I. Management of Anaesthesia during tracheal resection. Anaesthesia,29: 761 (1974).

  12. 12.

    Lee, P. &English, I.C.W. Management of anaesthesia during tracheal resection. Anaesthesia,29: 305 (1974).

  13. 13.

    Ellis, R.H., Hinds, C.J., &Gadd, L.T. Management of anaesthesia during tracheal resection. Anaesthesia,31: 1076 (1976).

  14. 14.

    Macnaughton, F.I. Catheter inflation ventilation in tracheal stenosis. Brit. Jour. Anaes.,47: 1225 (1975).

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Correspondence to A. B. Ismail.

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Ismail, A.B. Anaesthesia for tracheal resection. Modified use of the carden tube. Canad. Anaesth. Soc. J. 26, 134 (1979). https://doi.org/10.1007/BF03013784

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Keywords

  • Tracheal Tube
  • Tracheostomy Tube
  • Tracheal Stenosis
  • Intermittent Positive Pressure Ventilation
  • Suction Catheter