Anesthetic management for a patient with severely obstructed upper airway undergoing CO2 laser resection of the tracheal tumor

A 76-year-old woman was scheduled to undergo a laser resection of the tracheal tumor which severely obstructed the upper airway. She had a past history of thoracic aortic aneurysm resection and myocardial infarction. After spraying the patient's oral cavity with 8% lidocaine, a laryngeal mask airway was inserted under spontaneous respiration. Tumor resection was successfully performed using CO2 laser through the laryngeal mask airway with the aid of low dose fentanyl under spontaneous respiration. Maintaining FIO2 at 0.5 could prevent hypoxemia. Although mild edema was observed in the larynx at the completion of the surgery, the patient achieved remarkable improvement in her breathing status. Consequently, she was able to undergo radiotherapy on the 5th postoperative day. This effectively reduced the tumor volume.