Unexpected tracheal narrowing during general anesthesia in the prone position of Duchenne muscular dystrophy patient -A report of two cases

• Published in: Korean journal of anesthesiology Vol. 64; no. 5; pp. 456 - 459
• Main Authors: Lee, Dong Kyu, Lim, Byung Gun, Lee, Il-Ok, Oh, Hye-Ran, Lim, Sang Ho, Lee, Mi Kyoung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01.05.2013; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: Case Report; duchenne muscular dystrophy; prone position; tracheal narrowing; 마취과학; Prone position; Tracheal narrowing; Duchenne muscular dystrophy
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kjae.2013.64.5.456

Unexpected tracheal narrowing was observed in a patient with Duchenne muscular dystrophy during a corrective operation for thoracolumbar scoliosis. As the operating time progressed, peak airway pressure and end-tidal CO2 increased gradually in the prone position. We found a floppy portion of the trachea using fiberoptic bronchoscopy (FB) in the prone position. We advanced a wire-reinforced tube toward the carina beyond the lesion. This allowed correction of the ventilatory abnormalities. We encountered another patient scheduled for the same operation. We performed FB in advance before the position change and observed a narrowed portion of trachea. We advanced the tracheal tube under FB beyond the pathologic portion and then moved the patient into the prone position. The operation was done successfully without any problems.