Abstract
A 88-year-old man was scheduled for ventral hernia repair. His preanesthetic chest X-ray had not revealed airway abnormality. Anesthesia was induced with propofol and maintained with sevoflurane and nitrous oxide and oxygen. The operation was finished uneventfully. Immediately the tracheal tube was extubated, arterial oxygen saturation measured by pulse oximeter decreased to 70%, and he developed respiratory effort and stridor. Chest X-ray after reintubation showed tracheal arcuation with a shift to the right side, and we found tracheal stenosis by bronchofiberscopy. The oxygenation was improved by putting him into the sitting position, and the tracheal tube was removed the following day.
Intra-abdominal hypertension induced by repair of hernial sac might cause tracheal arcuation. However, the contributions of advanced age and obesity cannot be denied. We should be alert for intra-abdominal pressure and airway management during the repair of ventral hernia.
