Awake intubation in a patient with huge orocutaneous fistula: a case report.
10.17245/jdapm.2017.17.4.313
- Author:
Hye Jin KIM
1
;
So Hyun KIM
;
Tae Heung KIM
;
Ji Young YOON
;
Cheul Hong KIM
;
Eun Jung KIM
Author Information
1. Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
- Publication Type:Case Report
- Keywords:
Difficult Mask Ventilation;
Mandibular Reconstruction;
Orocutaneous Fistula
- MeSH:
Airway Management;
Anesthesia, General;
Dexmedetomidine;
Female;
Fistula*;
Humans;
Intubation*;
Intubation, Intratracheal;
Laryngoscopes;
Mandibular Reconstruction;
Masks;
Middle Aged;
Neck Dissection;
Thigh;
Ventilation
- From:Journal of Dental Anesthesia and Pain Medicine
2017;17(4):313-316
- CountryRepublic of Korea
- Language:English
-
Abstract:
Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.
