One-Lung Ventilation and Anesthetic/Analgesic Management in a 25-Month-Old Pediatric Patient

Öz

Congenital pulmonary adenomatoid malformation (CPAM) is a rare pulmonary anomaly requiring surgical intervention in pediatric patients. This case report evaluates one-lung ventilation and anesthetic management in a 25-month-old male patient scheduled for right lower lobectomy via video-assisted thoracoscopic surgery (VATS). Intubation was performed using a 4-mm cuffed endotracheal tube under fiberoptic bronchoscopy guidance, and successful lung isolation was achieved using a bronchial blocker. Lung-protective ventilation strategies were implemented during mechanical ventilation, and erector spinae plane block was performed as part of multimodal analgesia. Hemodynamic stability was maintained during the intraoperative period, and no additional analgesic requirements were needed within the first 24 hours postoperatively. This case demonstrates the safe and effective use of fiberoptic bronchoscopy-guided one-lung ventilation and advanced anesthetic techniques in pediatric thoracic surgery.

Anahtar Kelimeler

• Congenital pulmonary adenomatoid malformation
• One-lung ventilation
• Fiberoptic bronchoscopy
• Pediatric anesthesia
• Bronchial blocker

Yirmi Beş Aylık Pediatrik Hastada Tek Akciğer Ventilasyonu ve Anestezi/Analjezi Yönetimi

Öz

Konjenital pulmoner adenomatoid malformasyon (CPAM), pediatrik hastalarda cerrahi müdahale gerektiren nadir bir akciğer anomalisidir. Bu olgu sunumunda, 25 aylık erkek hastada video yardımlı torakoskopik cerrahi (VATS) ile sağ alt lobektomi planlanan vakada tek akciğer ventilasyonu ve anestezi yönetimi değerlendirilmiştir. Fiberoptik bronkoskopi rehberliğinde 4 mm kaflı endotrakeal tüp ile entübasyon yapılmış, bronşiyal bloker kullanılarak başarılı akciğer izolasyonu sağlanmıştır. Mekanik ventilasyonda akciğer koruyucu stratejiler uygulanmış, multimodal analjezi kapsamında erectör spina plane bloğu gerçekleştirilmiştir. İntraoperatif dönemde hemodinamik stabilite korunmuş, postoperatif 24 saatte ek analjezi ihtiyacı olmamıştır. Bu vaka, pediatrik toraks cerrahisinde fiberoptik bronkoskopi eşlikli tek akciğer ventilasyonu ve ileri anestezi tekniklerinin güvenli ve etkili kullanımını göstermektedir.

Anahtar Kelimeler

• Konjenital pulmoner adenomatoid malformasyon
• Tek akciğer ventilasyonu
• Fiberoptik bronkoskopi
• Pediatrik anestezi
• Bronşiyal bloker

Kaynakça

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