Anesthetic management of airway stent placement by rigid bronchoscopy with superior laryngeal nerve block while preserving spontaneous breathing: A case report

• Published in: Clinical case reports Vol. 11; no. 11; pp. e8232 - n/a
• Main Authors: Okada, Toshio, Yoshida, Mio, Matsushita, Tomoko, Ishida, Yusuke, Furukawa, Kinya, Murozono, Michihiro
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-11-2023; Wiley
• Subjects: air way stent; Airway management; Anesthesia; Bronchoscopy; Cartilage; Case reports; Fentanyl; Hypoxia; Intubation; Larynx; Lymphatic system; Patient satisfaction; Silicones; spontaneous breathing maintenance; Stents; superior laryngeal nerve block; Thyroid gland; Tomography; Ultrasonic imaging; United States > US; Japan; superior laryngeal nerve block; spontaneous breathing maintenance; air way stent
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.8232

Key Clinical Message
The combination of superior laryngeal nerve block can reduce the respiratory depression that occurs during management under total intravenous anesthesia.
Anesthetic management of endobronchial stent placement by rigid bronchoscopy requires the maintenance of spontaneous breathing while suppressing upper airway reflexes. The combination of superior laryngeal nerve block (SLNB) can reduce the respiratory depression that occurs during management under total intravenous anesthesia. The patient was diagnosed as having lung cancer with invasion into the right middle bronchus and stenosis of the right main bronchus on chest computed tomography, and emergency airway stent placement was performed. Sedation was initiated with propofol and dexmedetomidine, and ultrasound‐guided SLNB was performed after local anesthetic spraying into the oral cavity and trachea. Bucking was minimally controlled during insertion of the rigid bronchoscope. The patient's intraoperative hemodynamics remained stable, and there were no hypoxic events. SLNB can provide the suppression of the upper airway reflex while minimizing effects on spontaneous breathing, and may be useful for achieving balanced anesthesia during rigid bronchoscopy.