Monitored Anesthesia Care for Conversion to Tracheostomy from Cricothyrotomy in a Patient with Severe Laryngeal Edema
نویسندگان
چکیده
急性喉頭浮腫の発症後に輪状甲状間膜切開による気道確保がなされた患者の気管切開術の麻酔を経験した．輪状甲状間膜切開と同日に，気管切開術が予定され全身麻酔が依頼された．発症は食事後約30分後であったため，原因としてアナフィラキシーが疑われていた．患者に全身麻酔歴はなかった．主治医と協議の上，すでに一定の安全性が確認されていた麻酔薬のみを用いて局所麻酔と意識下鎮静法で麻酔を維持した．意識下気管切開術は患者に与えるストレスが大きいが，全身麻酔薬の使用に安全性が確認されていない場合や気道確保のために自発呼吸を維持すべき場合などで選択されることがある．患者，麻酔科医，執刀医の連携が極めて重要な麻酔法である．
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ژورنال
عنوان ژورنال: The Journal of Japan Society for Clinical Anesthesia
سال: 2022
ISSN: ['0285-4945', '1349-9149']
DOI: https://doi.org/10.2199/jjsca.42.317