%0 Journal Article
%T Anesthetic and Airways Management of a Dog with Severe Tracheal Collapse during Intraluminal Stent Placement
%A M. Argano
%A K. Gendron
%A U. Rytz
%A C. Adami
%J Case Reports in Veterinary Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/234598
%X This case report describes the anesthetic and airways management of a dog affected by 4th degree tracheal collapse and undergoing endoscope-guided intraluminal stent placement. After premedication with acepromazine and butorphanol, general anesthesia was induced with propofol and maintained with intravenous propofol and butorphanol in constant rate infusion. During intraluminal stent placement, oxygen was supplemented by means of a simple and inexpensive handmade device, namely, a ureteral catheter inserted into the trachea and connected to an oxygen source, which allowed for the maintenance of airways¡¯ patency and adequate patient¡¯s oxygenation, without decreasing visibility in the surgical field or interfering with the procedure. The use of the technique described in the present paper was the main determinant of the successful anesthetic management and may be proposed for similar critical cases in which surgical manipulation of the tracheal lumen, which may potentially result in hypoxia by compromising airways patency, is required. 1. Introduction Tracheal collapse is a progressive condition which mainly affects small-breed dogs, characterized by degeneration of the hyaline cartilage rings and weakening of the dorsal trachealis muscle [1, 2]. Besides conservative medical management, which is reported to palliate clinical symptoms for several years in most cases [3], more invasive treatment options are either surgical application of extraluminal rings [4¨C8] or endoscope-guided intraluminal stent placement [9¨C14]. The latter, although considered minimally invasive [7], is the most challenging in terms of anesthetic management, owing to the difficulty of maintaining the airways patent throughout the entire procedure. In order to perform the surgery in a safely intubated patient, the endoscope¡¯s distal end may be inserted into the trachea through the endotracheal tube (ETT). However, this technique entails some drawbacks, such as limited visibility of the surgical field and, especially in toy breeds in which only small diameter ETT can be placed, obstruction of the ETT lumen. Thereby, it is generally preferred to have the trachea not to be intubated during intraluminal stents placement. On the other hand, even in case of nonintubated airways, the endoscope¡¯s tube itself may narrow the tracheal lumen enough to compromise oxygenation. Oxygen supplementation may be provided by means of different methods, although none of them seem to be optimal for surgical procedures involving the tracheal lumen in terms of efficiency, simplicity, and practicability. Jet
%U http://www.hindawi.com/journals/crivem/2013/234598/