1 YAŞINDAKİ ÇOCUKTA TRAKEAL REZEKSİYON SIRASINDA ANESTEZİ YÖNETİMİ


Güleç E., Türktan M., Karacaer F.

6th INTERNATIONAL ZEUGMA CONFERENCE ON SCIENTIFIC RESEARCHES, Gaziantep, Türkiye, 19 - 20 Haziran 2021, ss.27-28

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Gaziantep
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.27-28
  • Çukurova Üniversitesi Adresli: Evet

Özet

Abstract Background: Tracheal stenosis is an important complication of long-term intubation or tracheostomy. Tracheal resection with end-to-end anastomosis is an effective surgical method. Although it is frequently applied to adult patients, pediatric patients are limited in the literature. We aimed to investigate the anesthetic management of a 1-year-old child during tracheal resection. Materials and methods: A 1-year-old male patient had an inguinal hernia operation at the age of 20 days and liver transplantation at the age of 5 months. Tracheostomy was performed considering laryngomalacia at the postoperative period after transplantation surgery. In the follow-up with silver cannula, tracheal stenosis was diagnosed due to respiratory problems and tracheal resection surgery was planned. Results and discussion: Patient with tracheostomy was monitored using noninvasive blood pressure, pulse oximetry, ECG; temperature and capnography was added after intubation. Anesthesia was induced via tracheostomy cannula with sevoflurane in 50%+%50 N2O+ O2. After anesthesia induction, rocuronium bromide was administered. Anesthesia was maintained with sevoflurane %1-2 and 50%+%50 N2O+O2. Tracheostomy area was debrided with collar incision, sterile intubation tube was inserted through the distal tip of the tracheal incision, sterile anesthesia circuit was attached, and ventilation was started in this way. Approximately 2 cm of trachea was resected. After the posterior trachea was anastomosed end-to-end, the patient was intubated orally endotracheal tube and sterile tube was removed. Tracheal anastomosis was completed after observing oral intubation tube crossed the anastomosis line. All layers were closed after controlling for air leakage, foreign body and bleeding. The surgery was terminated after stability of the anastomosis line was seen with rigid bronchoscopy. Intravenously morphine 1 mg and paracetamol 150 mg were given for postoperative analgesia. The patient was taken to the pediatric intensive care unit for postoperative follow-up. He was extubated on the 10th postoperative day and taken to the ward room on the 14th postoperative day. Patient was discharged on the 17th day of hospitalization without any problems. Conclusion: Tracheal resection with end-to-end anastomosis can be performed safely in pediatric patients as in adults. Close communication with the surgical and anesthesia team increases success of the surgery. Key words: tracheal resection, anastomosis, child