Authors : Ajit Kumar; Umang Sharma; Mohammad Azhar Khan; Tanzim Akram; Abhisek Dey

Volume/Issue : Volume 11 - 2026, Issue 9 - September

Google Scholar : https://tinyurl.com/mr3x7hfs

DOI : https://doi.org/10.38124/ijisrt/26sep834

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Prolonged mechanical ventilation via tracheostomy is a recognised cause of acquired subglottic and tracheal stenosis. Anaesthetic management for endoscopic tracheal dilation in such patients is challenging, particularly when coexisting tracheomalacia raises concern for dynamic airway collapse with neuromuscular blockade, and when concurrent laser use mandates a low fraction of inspired oxygen (FiO2). We report the case of a 23-year-old male who developed CottonMyer grade III subglottic/tracheal stenosis after four months of tracheostomy-assisted ventilation following exploratory laparotomy for blunt abdominal trauma. He underwent tracheal dilation using a muscle-relaxant-free, spontaneousventilation technique with a dexmedetomidine infusion (loading dose 1 mcg/kg over 10 minutes, maintenance 0.3 mcg/kg/hour), high-dose fentanyl, and a supraglottic airway device (i-gel), at low FiO2 to accommodate simultaneous laser use. This approach preserved spontaneous respiration, avoided airway collapse, minimised operating room pollution, and maintained an adequate depth of anaesthesia throughout the procedure.

Keywords : Dexmedetomidine; Subglottic Stenosis; Tracheomalacia; Spontaneous Ventilation; Tubeless Anaesthesia; Laser Airway Surgery; Tracheal Dilation.

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