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

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.

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.

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.