Intravenous anesthesia for surgery one cases of esophageal fistula.docVIP

 PAGE \* MERGEFORMAT 6 Intravenous anesthesia for surgery one cases of esophageal fistula [Keywords:] Anesthesia, intravenous; bronchial fistula; esophageal fistula Esophageal fistula is divided into two kinds of congenital and secondary, congenital esophageal fistula is due to embryos 4 to 5 weeks on both sides of the trachea, esophagus does not heal completely, resulting in the esophagus, trachea septal defect, he can not lift this part of the foregut divided into ventral and dorsal esophageal trachea, so that two channels left between the traffic Tao [1]. Secondary esophageal fistula is due to mediastinal lymph nodes, trachea, lung and esophagus itself caused by tuberculosis and chronic inflammation [2]. The patients are secondary esophageal fistula. A clinical data Patients, female, 39 years old, weight 44 kg. A result of drinking water, eating frequent episodes of choking more than 10 years admitted to hospital. Preoperative diagnosis of esophageal fistula. Preoperative electronic bronchoscope distal segment showed a right dorsal fistula, CT showed the right middle and lower lung bronchiectasis and infection, bronchiectasis left lung segment under the tongue, no clear esophageal - tracheal fistula. X-gastrointestinal radiography in line with esophageal - tracheal fistula signs of right lower lung infection and signs of the right side of a small amount of pleural effusion. Report of pulmonary function tests pulmonary function was normal, mild airway obstruction, pulmonary peripheral elastic resistance and frequency-dependent increase in ventilation reserves 86%. The patient usually can not be completely supine, improved after the stomach tube. Into the operating room after the blood pressure 140/82 mmHg, heart rate 94 times / min, blood oxygen partial pressure 96%, central venous pressure (CVP) of 4 cmH2O. Open venous channel, given the turn of infusion liquid crystal gel, CVP increased to 7 cmH2O. Start induction of anesthesia, followed by intravenous