Sedation with Dexmedetomidine during Tracheostomy in Severe Tracheal Stenotic Patients
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In patients with severely compromised airways, a tracheostomy is usually performed under local anesthesia. Dexmedetomidine can be a better choice of sedative for such patients because it causes minimal respiratory depression. We report two cases of patients with severe stenosis of the airways who underwent sedation with dexmedetomidine during tracheostomy under local anesthesia. In the first case, recurrent laryngeal cancer caused laryngeal stenosis, and the narrowest laryngeal width was less than 3 mm. In the second case,the tracheostomy opening site was narrowed to a diameter of 3.4 mm in a patient with a history of total laryngectomy. For both patients,sedation was induced by dexmedetomidine infusion and the tracheostomy was performed successfully under local anesthesia without any events. Dexmedetomidine seems to be an effective and safe sedative for tracheostomies in patients with critical airways. The management and implications of sedation with dexmedetomidine in the patients with severe stenotic airways are discussed.
Abstract
In patients with severely compromised airways, a tracheostomy is usually performed under local anesthesia. Dexmedetomidine can be a better choice of sedative for such patients because it causes minimal respiratory depression. We report two cases of patients with severe stenosis of the airways who underwent sedation with dexmedetomidine during tracheostomy under local anesthesia. In the first case, recurrent laryngeal cancer caused laryngeal stenosis, and the narrowest laryngeal width was less than 3 mm. In the second case,the tracheostomy opening site was narrowed to a diameter of 3.4 mm in a patient with a history of total laryngectomy. For both patients,sedation was induced by dexmedetomidine infusion and the tracheostomy was performed successfully under local anesthesia without any events. Dexmedetomidine seems to be an effective and safe sedative for tracheostomies in patients with critical airways. The management and implications of sedation with dexmedetomidine in the patients with severe stenotic airways are discussed.
참고문헌 (14)
- 이수경, "Clinical use of dexmedetomidine in monitored anesthesia care", Korean Journal of Anesthesiology, 61(6), pp.451~452 (2011), 대한마취통증의학회
- Lee S, "Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in healthy Korean subjects", J Clin Pharm Ther, 37, pp.698~703 (2012)
- Venn RM, "Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care", Crit Care, 4, pp.302~308 (2000)
- Abdelmalak B, "Dexmedetomidine as sole sedative for awake intubation in management of the critical airway", J Clin Anesth, 19, pp.370~373 (2007)
- Hall JE, "Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions", Anesth Analg, 90, pp.699~705 (2000)
- Farag E, "The use of dexmedetomidine in anesthesia and intensive care: a review", Curr Pharm Des, 18, pp.6257~6265 (2012)
- Bergese SD, "Dexmedetomidine for conscious sedation in difficult awake fiberoptic intubation cases", J Clin Anesth, 19, pp.141~144 (2007)
- David MD, "Dexmedetomidine sedation for awake tracheotomy: case report and literature review", J Clin Anesth, 22, pp.360~362 (2010)
- Shukry M, "Update on dexmedetomidine: use in nonintubated patients requiring sedation for surgical procedures", Ther Clin Risk Manag, 15, pp.111~121 (2010)
- Ramsay MA, "Dexmedetomidine as a total intravenous anesthetic agent", Anesthesiology, 101, pp.787~790 (2004)
- Belleville JP, "Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate", Anesthesiology, 77, pp.1125~1133 (1992)
- Liao W, "Dexmedetomidine versus midazolam for conscious sedation in postoperative patients undergoing flexible bronchoscopy: a randomized study", J Int Med Res, 40, pp.1371~1380 (2012)
- Hu R, "Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation: a double-blinded randomized controlled trial", J Anesth, 27, pp.211~217 (2013)
- Kawaai H, "A comparison of intravenous sedation with two doses of dexmedetomidine: 0.2μg", kg, kg, pp.hr, Anesth Prog[DOI]