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Korean J Crit Care Med > Volume 28(4); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(4): 314-317. doi: https://doi.org/10.4266/kjccm.2013.28.4.314
심한 기도협착 환자에서 기관 절개 시 Dexmedetomidine을 이용한 진정
전인정ㆍ김계민ㆍ이상석ㆍ유병훈ㆍ이우용ㆍ임윤희ㆍ송세진ㆍ김문철
Sedation with Dexmedetomidine during Tracheostomy in Severe Tracheal Stenotic Patients
Injung Jun, Kye Min Kim, Sang Seok Lee, Byung Hoon Yoo, Yoo Yong Lee, Yun Hee Lim, Se Jin Song, Mun Cheol Kim
Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. kmcan@paran.com
ABSTRACT
In patients with severely compromised airways, a tracheostomy is usually performed under local anesthesia. Dexmedetomidine can be a better choice of sedative for such patients because it causes minimal respiratory depression. We report two cases of patients with severe stenosis of the airways who underwent sedation with dexmedetomidine during tracheostomy under local anesthesia. In the first case, recurrent laryngeal cancer caused laryngeal stenosis, and the narrowest laryngeal width was less than 3 mm. In the second case, the tracheostomy opening site was narrowed to a diameter of 3.4 mm in a patient with a history of total laryngectomy. For both patients, sedation was induced by dexmedetomidine infusion and the tracheostomy was performed successfully under local anesthesia without any events. Dexmedetomidine seems to be an effective and safe sedative for tracheostomies in patients with critical airways. The management and implications of sedation with dexmedetomidine in the patients with severe stenotic airways are discussed.
Key Words: dexmedetomidine; sedation; tracheostomy
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