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Anesthesiology pp 113-118 | Cite as

Anesthesia for Tracheal Surgery

  • Philip L. Kalarickal
  • Stephanie Opusunju Ibekwe
Chapter

Abstract

Tracheal resection and reconstructive surgeries are advanced procedures that require coordination and communication between anesthesiology and surgical teams. Common causes for resection include trauma, subglottic stenosis from prolonged intubation, tracheal masses and congenital causes. A thorough preoperative evaluation including pulmonary function distal to the stenotic portion of trachea is essential. A safe plan to initially secure the airway can be a challenge and the option of an elective awake tracheostomy should be considered. Total intravenous anesthesia should be considered to avoid pollution of the operating room and provide consistent anesthetic delivery. Extubation considerations include ensuring adequate ventilation and avoidance of stimulation, coughing or bucking which can catastrophically disrupt the new tracheal suture lines. Table 13.2, summarizes the anesthetic considerations in patents undergoing tracheal surgery.

Keywords

Trachea Resection Tracheal reconstruction Communication Airway anatomy Tracheal obstruction Airway management 

References

  1. 1.
    Hobai IA, Changani SV, Alfille PH. Anesthesia for tracheal resection and reconstruction. Anesthesiol Clin. 2012;30:709–30.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pinsonneault CCA, Fortier J, Donati F. Tracheal resection and reconstruction. Can J Anesth. 1999;46:439–55.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Sandberg W. Anesthesia and airway management for tracheal resection and reconstruction. Int Anesthesiol Clin. 2000;38:55–75.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Roman PE, Battafarano RJ, Grigore AM. Anesthesia for tracheal reconstruction and transplantation. Curr Opin Anaesthesiol. 2013;26:1–5.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Geffin B, Bland J, Grillo HC. Anesthetic management of tracheal resection and reconstruction. Anesth Analg. 1969;48:884–90.CrossRefPubMedGoogle Scholar
  6. 6.
    Mathisen DJ. Complications of tracheal surgery. Chest Surg Clin N Am. 1996;6:853–64.PubMedGoogle Scholar
  7. 7.
    Kaiser LR, Kron IL, Spray TL. Tracheal resection and reconstruction. In: Mastery of cardiothoracic surgery. Philadelphia: Lippincott, Williams & Wilkins; 2007. p. 85–90.Google Scholar
  8. 8.
    McRae K. Anesthesia for airway surgery. Anesthesiol Clin North Am. 2001;19:497–541.CrossRefGoogle Scholar
  9. 9.
    Waddell TK, Uy KFL. Techniques of Tracheal Resection and Reconstruction. In: Sugarbaker DJ, Bueno R, Colson YL, Jaklitsch MT, Krasna MJ, Mentzer SJ eds. Adult Chest Surgery, 2nd ed. China: McGraw-Hill Education; 2015.Google Scholar
  10. 10.
    Saravanan P, Marnane C, Morris EAJ. Extubation of the surgically resected airway—a role for remifentanil and propofol infusions. Can J Anesth. 2006;53:507–11.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Philip L. Kalarickal
    • 1
  • Stephanie Opusunju Ibekwe
    • 1
  1. 1.Emory University School of MedicineAtlantaUSA

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