Anesthesia management of difficult airway secondary to craniocerebral perforation injury in child: a case report

Abstract

Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. Rare cases of difficult airway after craniocerebral perforating injury at the bottom of mouth have been reported. We performed airway and anesthesia management in a 17-month old girl, who suffered from traumatic brain injury, caused by a chopstick perforating the cranial from the mouth. Before removing the chopstick, we modified the face mask for oxygenation and inhalational anesthesia, and then conducted branchial intubation under the fiberbronchoscopy. Anesthesia was induced by combining intravenous and inhalational anesthesia, in which inhalational sevoflurane was administered at tidal volumes. During the operation, cricoid compression method was used to prevent inhalation of gastric content following regurgitation. These strategies for operative anesthesia management effectively maintained normal vital signs in this case, based on which the chopstick was removed and traumatic brain injury was successfully treated. Key words: Craniocerebral perforation injury; Difficult airway; Anesthesia management