Sedoanalgesia with dexmedetomidine and ketamine during endoscopic resection of an obstructing tumor of tracheal bifurcation in the patient with lung cancer and its atelectasis
https://doi.org/10.21292/2078-5658-2019-16-5-61-64
Abstract
The technique of multimodal sedoanalgesia with dexmedetomidine (DMM) and ketamine in combination with lidocaine, which was used in 55 years old male patient for loop electroexcision of a tumor of the right main bronchus, originating from the right lung (adenocarcinoma), which caused atelectasis of this lung and prolapsing into the bifurcation region, is presented. The endotracheal fragment of the tumor periodically blocked the mouth of the left main bronchus, causing attacks of asphyxiation. DMM has the unique ability to cause efficient sedation and moderate analgesia in combination with an antistress effect, and most importantly, without spontaneous breathing depression. In similar situations, these properties of DMM make it an agent of choice for anesthetic management. When working in reflexogenic zones, the addition of small doses of ketamine can increase the effectiveness of the method due to analgesic properties and insignificant effect on respiration. Intravenous administration of lidocaine plus terminal anesthesia with this local anesthetic complements the anesthetic protection.
About the Authors
E. S. Gorobets
Blokhin Russian Oncology Research Center
Russian Federation
Russian Federation
Evgeny S. Gorobets - Doctor of Medical Sciences, Professor, Senior Researcher of Anesthesiology and Intensive Care Department.
24, Kashirskoye Highway, Moscow, 115478.
A. R. Shin
Blokhin Russian Oncology Research Center
Russian Federation
Russian Federation
Aleksandr R. Shin - Candidate of Medical Sciences, Head of Anesthesiology and Intensive Care Department.
24, Kashirskoye Highway, Moscow, 115478.
L. V. Cherkes
Blokhin Russian Oncology Research Center
Russian Federation
Russian Federation
Leonid V. Cherkes - Candidate of Medical Sciences, Senior Researcher of Endoscopy Department.
24, Kashirskoye Highway, Moscow, 115478.
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Review
For citations:
Gorobets E.S., Shin A.R., Cherkes L.V. Sedoanalgesia with dexmedetomidine and ketamine during endoscopic resection of an obstructing tumor of tracheal bifurcation in the patient with lung cancer and its atelectasis. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(5):61-64. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-5-61-64
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