Anaesthesia for Central Airway Obstruction

A 55-year-old male with a history of exertional breathlessness for 5 months, haemoptysis for 2 weeks and acute onset stridor for a day presented to the emergency department. He was a chronic smoker for 30 years (20 pack years). On examination, he was found to have a heart rate of 100/min and respiratory rate of 35/min along with stridor and difficulty speaking in sentences. He was in a propped-up position. Respiratory system auscultation revealed extensive rhonchi and crept with a room air saturation of 90%. There was the use of accessory muscles for respiration. ABG revealed Pa02 58 mm Hg and PaCO2 60 mm Hg, pH 7.1 Multi-slice CT scan showed the presence of a tracheal mass with 5 mm stenosis together with dynamic airway collapse. He was posted for rigid bronchoscopy and tracheal stenting.