Open AccessAnaesthetic management of a patient with complete tracheal rupture following blunt chest trauma
Author(s) -
Saikat Sengupta,
Anjol Saikia,
Suresh Ramasubban,
Shaikat Gupta,
Saumen Kumar Maitra,
A Rudra,
Gaurab Maitra
Publication year - 2008
Publication title -
annals of cardiac anaesthesia/annals of cardiac anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 27
eISSN - 0974-5181
pISSN - 0971-9784
DOI - 10.4103/0971-9784.41582
Subject(s) - medicine , blunt , rocuronium , airway management , airway , surgery , propofol , endotracheal tube , anesthesia , tracheal tube , general anaesthesia , intubation
Complete tracheal resection is extremely rare after blunt chest trauma. A high degree of suspicion is essential to identify these cases and early intervention is associated with better outcome. We report a patient with complete tracheal resection, in whom the airway was secured whilst the patient remained awake, breathing spontaneously under fibreoptic bronchoscopic guidance. As a precautionary measure, we had kept cardiopulmonary bypass set up in readiness. Anaesthetic management needed to be modified during repair of the trachea, by using total intravenous anaesthesia with propofol and rocuronium infusion and insertion of a separate endotracheal tube into the distal portion of the trachea whilst reconstruction of the trachea took place. The usual inhalational technique could not be used. The anaesthesiologist managing such a case should be aware of the difficulties during securing the airway and during repair of the trachea. Proper planning and keeping back-up plans ready helps in successful management of these patients.