Anesthetic Management with PCPS for Tracheobronchial Stent Insertion

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  • OGATA Yuichi
    Department of Anesthesiology, University of Occupational and Environmental Health
  • HORISHITA Takafumi
    Department of Anesthesiology, University of Occupational and Environmental Health
  • TSUCHIYAMA Reiko
    Department of Anesthesiology, University of Occupational and Environmental Health
  • KAWASAKI Takashi
    Department of Anesthesiology, University of Occupational and Environmental Health

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Other Title
  • PCPSを用いた気管ステント留置術の麻酔経験

Description

<p>A tracheobronchial stent insertion was scheduled under general anesthesia in a 67-year-old man with a gastric tube-bronchial fistula after esophagectomy for cancer. Because the duration of apnea was expected to be long, we decided to use percutaneous cardiopulmonary support（PCPS）for gas exchange. The catheter insertion for PCPS was done under spinal anesthesia to eliminate pain during the procedure. Total intravenous anesthesia was performed after PCPS started, and the patient was intubated orally. When the Y-stent was inserted through a rigid bronchoscope, the patient had to be extubated. After extubation, oxygen saturation in his right hand dropped temporarily, whereas that in his left hand remained at 100%. This discrepancy occurred because arterial blood that was not fully oxygenated circulated in his right limb due to cardiac output rather than PCPS. We could minimize this desaturation in the right limb by ventilating the right lung through intubation into the right main trachea. We were able to manage this patient without critical accidents through detailed planning and special attention under PCPS.</p>

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