Case Report:Spontaneous breathing and anesthetic management of patients with tracheomediastinal fistula during carotid stent removal

Abstract

Abstract Purpose: To report the anesthetic management in a patient with a tracheomediastinal fistula who underwent a successful internal carotid stent removal and cervical esophageal fistula debridement. Clinical Features: A 58-yr-old man with a tracheomediastinal fistula was subjected to carotid stent removal and cervical esophageal debridement under general anesthesia. Blood tests showed mild anemia and hypoproteinemia, four coagulation items and normal electrocardiogram. Tracheoscopy revealed a tracheomediastinal fistula. The patient had a history of cerebral infarction after left middle cerebral artery stenting. To meet surgical requirements and allow the effective management of his airway, we used propofol and sufentanil for intravenous anesthesia, cervical plexus block and spontaneous breathing under intubation. Conclusions: For this particular case, propofol and sufentanil intravenous anesthesia, coupled. With cervical plexus block and spontaneous breathing, met the surgical requirements and allowed the effective management of patient airway.