An awake double lumen endotracheal tube intubation using the Clarus Video System in a patient with an epiglottic cyst: a case report.
10.4097/kjae.2014.66.2.157
- Author:
Hyungseok SEO
1
;
Gunn LEE
;
Seung Il HA
;
Jun Gol SONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jungol.song@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Airway obstruction;
Difficult intubation;
Laryngeal mass
- MeSH:
Airway Obstruction;
Epiglottis;
Fentanyl;
Glycopyrrolate;
Humans;
Intubation*;
Laryngeal Nerves;
Laryngoscopy;
Lidocaine;
Male;
Midazolam;
Middle Aged;
Oropharynx;
Oxygen;
Pancreaticoduodenectomy;
Recovery Room;
Thoracic Surgery, Video-Assisted
- From:Korean Journal of Anesthesiology
2014;66(2):157-159
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 54-year-old male patient was scheduled for an elective pylorus-preserving pancreaticoduodenectomy combined with video-assisted thoracic surgery at our hospital. This patient had a history of intubation failure in other institutions due to an epiglottic cyst. An airway assessment of the patient was normal. A preoperative laryngoscopy revealed a bulging epiglottic mass covering most of the epiglottis and occupying most of the pharyngeal space. The patient was administered intravenous midazolam 1 mg, fentanyl 50 microg, and glycopyrrolate 0.2 mg. A bilateral superior laryngeal nerve block was then performed with 2% lidocaine 2 ml on each side. A 10% lidocaine spray was applied on to the oropharynx. After preoxygenation with 100% oxygen over 10 minutes, a rigid fiberscope with an optical stylet loaded with a 37 Fr double lumen endotracheal tube was inserted orally and passed into the glottic aperture. The patient was fully awakened after surgical procedure and was transferred to the recovery room after extubation.
