Anesthesia for Tracheal Surgery

Abstract

Tracheal resection and reconstructive surgeries are advanced procedures that require coordination and communication between anesthesiology and surgical teams. Common causes for resection include trauma, subglottic stenosis from prolonged intubation, tracheal masses and congenital causes. A thorough preoperative evaluation including pulmonary function distal to the stenotic portion of trachea is essential. A safe plan to initially secure the airway can be a challenge and the option of an elective awake tracheostomy should be considered. Total intravenous anesthesia should be considered to avoid pollution of the operating room and provide consistent anesthetic delivery. Extubation considerations include ensuring adequate ventilation and avoidance of stimulation, coughing or bucking which can catastrophically disrupt the new tracheal suture lines. Table 13.2, summarizes the anesthetic considerations in patents undergoing tracheal surgery.