LOW CARINAL TUMOR & AIRWAY MANAGEMENT : AN ANESTHETIC CHALLENGE

Abstract

OBJECTIVE : Aim of the study was to face challenges during airway surgeries since airway is shared by both surgeon
& anesthesiologist during tracheal resection, it is imperative to maintain ventilation ,while allowing free surgical access
at the same time for the surgeons.
METHODOLOGY: Plane of anaesthesia was APNEIC VENTILATION along with intermittent mass ventilation along with EtCO2
monitoring . During procedure , SpO2 once reached upto 70 % which required ventilation with 100 % O2 and even intermittent suction of
surgical site was done simultaneously. Even after thorough suction of surgical site and mask ventilation with 100% O2 , there was no
improvement in saturation . Therefore Surgeons were requested to abandon the procedure. Endo-tracheal intubation was done with 6.5 mm prtex
,cuffed ET tube inserted. Endo-tracheal suction was done which revealed excessive bleeding. Suction was followed by nebulization with duolin
, budecort , adrenaline. After that, once SpO2 reached to 96 % , endotracheal tube was removed.
RESULT: Patient was shifted to post operative recovery room to monitor hypoxia and respiratory distress. Patient was kept in head up position
with oxygen via facemask [FiO2-0.5] along with nebulization. Patient was advised to continue steroid 8 hourly . Post-opertive Chest X ray [PA]
also advised. Post operative ABGA shows Pao2 of 94%.
CONCLUSION: Good communication, coordination and cooperation between the surgeon and the anesthesiologist are mandatory throughout
the perioperative period for the successful outcome and the anesthesiologist should have the knowledge of other airway management techniques
and be ready with an alternative plan in case of failure.