Effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae

JA Clin Rep. 2024 Nov 28;10(1):73. doi: 10.1186/s40981-024-00757-6.

Abstract

Background: Anesthetic management of a patient with multiple giant bullae is generally difficult due to an increased risk of respiratory complications, and there is no consensus regarding safe extubation methods. We report a case of an effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae, in whom a double-lumen bronchial tube was being used during anesthesia.

Case presentation: A 52-year-old man with multiple giant bullae underwent video-assisted pulmonary resections, while the ventilation was controlled via a double-lumen bronchial tube. After successful thoracoscopic surgery, an i-gel™ was inserted while the double-lumen tube was still in place, and the double-lumen tube was subsequently removed under deep anesthesia. The i-gel™ was removed without complications after the patient had become able to respond to verbal command.

Conclusion: We believe that this method would minimize the risk of trauma to the respiratory system during emergence from anesthesia in patients with multiple giant bullae.

Keywords: Giant bulla; Deep extubation; Laryngeal mask airway.