2016 Volume 36 Issue 4 Pages 404-411
Tracheobronchial stenting is a procedure in which a stent is inserted into a stenotic site of the airway. Which ventilation is optimal for tracheal stenting is controversial. In this study, we retrospectively investigated patients who had undergone tracheal stenting, and evaluated the incidence of oxygen desaturation (SpO2 : <95%), mean intraoperative P/F ratio, pH, and PaCO2 in spontaneous respiration (SP) and controlled ventilation with muscle relaxants (MR) groups.
Of patients who underwent tracheal stenting in our hospital between July and November 2013, we evaluated 10 patients each in the SP and MR groups.
For anesthesia, TIVA with propofol TCI and remifentanil was performed. In the SP group, spontaneous respiration was maintained. In the MR group, a rigid endoscope was inserted after the administration of muscle relaxants and controlled ventilation performed.
The incidences of oxygen desaturation in the SP and MR groups were 50 (n=5, 95%CI : 23 to 76%) and 0% (n=0, 95% CI : 0 to 28%), respectively.
In the SP group, the mean intraoperative pH was lower than in the MR group (7.26±0.05 vs. 7.40±0.07, respectively, P<0.001). In this group, the mean PaCO2 was higher (63.5±12.3 vs. 40.6±8.58, respectively, P<0.001), and the mean P/F ratio was lower (206.5±47.1 vs. 387.2±68.1, respectively, P<0.001).
Controlled ventilation with muscle relaxants during tracheal stenting reduced the incidence of oxygen desaturation, maintaining a favorable respiratory status.
Note : P/F ratio＝PaO2/FIO2
