Intravenous anesthesia


Anesthesia and Pain Medicine. 2006 June 10(2): 75-78
ⓒ Korean Society for Intravenous Anesthesia
Anesthetic Management using Intubating Laryngeal Mask Airway for Balloon Dilatation in a Patient with Tracheal Stenosis, A case report
Ji-Hun Park, M.D.1, Sang Kyi Lee, M.D.1,2, and Ji-Seon Son, M.D.1
1Department of Anesthesiology and Pain Medicine, 2Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea

In case of high tracheal stenosis sited near the vocal cord, it is difficult to manage airway using a cuffed tracheal tube because of high possibility of vocal cord injury, inadvertent extubation of the tube and inability to apply positive pressure ventilation. An intubating laryngeal mask airway (ILMA) is supraglottic airway device and can make maintenance of airway and ventilation effectively. Balloon dilatations were performed many times in a 22-year old female patient with tracheal stenosis in awake state. But it was impossible due to severe pain and discomfort causing frequent tracheal stenosis. Because of the tracheal stenotic region (length 5 cm ⁓ diameter 5.6 mm) was located 1⁣2 cm below the vocal cord, total intravenous general anesthesia using ILMA was considered. After giving propofol, alfentanil and succinylcholine, ILMA was placed without any problems. The patient was ventilated via ILMA, and several times of balloon dilatation were simultaneously executed through the inside lumen of the ILMA. Oxygenation and ventilation was safely maintained during the procedure. We report a case of high tracheal stenosis requiring balloon dilatation, where airway management was successful using the ILMA without any complications.
Key words : balloon dilatation, intubating laryngeal mask airway, tracheal stenosis
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