Conscious Sedation and Awake Fiberoptic Intubation in a Patient with Difficult Mask Ventilation—A Case Report

Bidur Kumar Baral,Hiroyuki Sasaki,Masahiro Uzawa,Mikito Kawamata,Kenkichi Kiyosawa,Susumu Ide

doi:10.4236/ojanes.2015.59037

Bidur Kumar Baral, Hiroyuki Sasaki + Show 4 more

Open Access

https://doi.org/10.4236/ojanes.2015.59037

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Abstract

Since maxillofacial malignancy is a common cause of facial defects and disfigurement of the face that may make fitting of a mask difficult and cause air leakage from the side, thus making mask ventilation difficult. In addition, distorted anatomy of the airway and base of the skull in such patients may cause difficult intubation (DI). We experienced a case with a huge facial defect due to maxillary carcinoma, in which difficult mask ventilation (DMV) and DI were predicted. After evaluation by three-dimensional airway computed tomography, the airway was secured with conscious sedation using dexmedetomidine, and awake fiberoptic intubation was safely performed. Three-dimensional airway computed tomography seems to be a good tool for successful intubation when DMV and DI are predicted.

Highlights

Difficult airway is still a challenge for anesthesiologists
Mask ventilation is the first step of airway management before endotracheal intubation or insertion of any airway devices
Mask ventilation became a major step in any difficult airway algorithm

Summary

Introduction

Difficult airway is still a challenge for anesthesiologists It includes difficult intubation (DI), difficult mask ventilation (DMV) or both. Since mask ventilation is a basic fundamental skill in airway management, every anesthesiologist should acquire skills for mask ventilation and should be knowledgeable about the causes of DMV. (2015) Conscious Sedation and Awake Fiberoptic Intubation in a Patient with Difficult Mask Ventilation—A Case Report. Mask ventilation is the first step of airway management before endotracheal intubation or insertion of any airway devices. It is a rescue technique when endotracheal intubation has failed or has become difficult. After evaluation by three-dimensional airway computed tomography, we managed the airway with conscious sedation using dexmedetomidine and AFOI

Case Summary

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