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నైరూప్య

Peri-Operative Anesthetic Management for Low Lying Tracheal Tumor; It is All About Sharing the Surgical Field between Anesthesia and Surgical Teams: A Case Report

Sirohiya Prashant, Vig Saurabh, Gulia Abhity, Ratre Brajesh K, Bharti Sachidanand J and Kumar Sunil

We describe a case of a 36-year-young male, presenting with complaints of cough, dyspnoea and hemoptysis. He was diagnosed to have a mass in the lower trachea. The patient was scheduled to undergo tracheal resection and reconstruction through a right posterolateral thoracotomy. A 7 French Arndt bronchial blocker was advanced into the right main stem bronchus distal to the tumor for one-lung ventilation; followed by direct in-field intubation of left endobronchial lumen post tracheal transaction with 6.5 mm flexometallic tube to provide one-lung ventilation after the opening of the trachea. Our airway management plan aimed to provide maximal surgical access to the trachea with adequate ventilation. Surgeon guided serratus anterior plane catheter was placed to facilitate post-operative analgesia. Airway management in lower tracheal tumors is a complex challenge requiring close coordination between the surgical and anesthetic teams. Adequate intraoperative and postoperative analgesia is an important aspect in tracheal resections done via thoracotomy. Both anesthetist and surgeon should have backup management plans for airway and analgesic management for optimum management and successful outcomes.