Anaesthesia for tracheal resection. Modified use of the Carden Tube

Surgical procedures involving sharing of the airway between the anaesthetist and surgeon, such as bronchoscopy, microlaryngeal surgery and tracheal resection impose special problems on the anaesthetist. The surgeon requires unrestricted surgical access, whereas the anaesthetist must ensure adequate and safe pulmonary ventilation and anaesthesia. This case report describes a two stage technique for management of the airway and ventilation during tracheal resection for stenosis. Initially a modified Carden tube with a ventilating injector was used through a tracheostomy stoma and subsequently an orotracheal tube was substituted. Anaesthesia was maintained entirely by the inravenous route. The surgical access was unrestricted and there was no pulmonary contamination.