Abstract

RASCON-MARTINEZ, Dulce M et al. Sedoanalgesia with ketodex for selective intubation in the resection of a giant aneurysm of the subclavian artery associated. Case report. Rev. mex. anestesiol. [online]. 2023, vol.46, n.4, pp.279-283.  Epub Feb 26, 2024. ISSN 0484-7903.  https://doi.org/10.35366/112301.

A giant subclavian artery aneurysm associated with superior vena cava syndrome occurs infrequently. Complexity of the approach will depend on the size, shape, and position of the aneurysm, particularly when a potential collapse of the airway is expected due to the compressive effect of the mediastinal mass after using neuromuscular relaxant for airway approach. We present a case in a 57-year-old male with shortness of breath in dorsal that increases with left lateral decubitus during five years of evolution. Radiological studies reported giant mediastinal mass compatible with an aneurysm of the right subclavian artery, which produces critical compression and airway displacement, particularly in trachea at level of the carina. The patient is scheduled for resection of the aneurysm and requires selective intubation for isolation of the right lung during surgery which was performed with the awake patient technique using sedoanalgesia with ketodex. The objective of the case is to share the experience using ketodex as an alternative for the tolerance of procedures that requires the cooperation of the patient where propofol and neuromuscular relaxant may be a problem for airway permeability and approach.

Keywords : ketodex; sedoanalgesia; selective intubation; subclavian artery aneurysm.

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