[Anesthesia for argon plasma coagulation therapy through the tracheostomy site]

We experienced a case of argon plasma coagulation (APC) therapy for bronchial obstruction. A 54-year-old man was scheduled for APC therapy for bronchial obstruction using bronchoscope via a tracheostoma. The patient had received left upper lobectomy four years before and laryngectomy and tracheotomy two years before. Anesthesia was induced with droperidol 2.5 mg, and gradual administration of fentanyl (total 125 microg) and midazolam (total 1 mg). Surgery was completed in 15 minutes under spontaneous breathing of air. In APC therapy, we cannot administer oxygen for fear of argon-ignited intratracheal combustion. Using small doses of droperidol, fentanyl, and midazolam, we could successfully anesthetize a patient for APC therapy through the tracheostomy site under spontaneous respiration with air.