Awake intubation in a patient with huge orocutaneous fistula: a case report
김혜진, 김소현, 김태흥, 윤지영, 김철홍, 김은정,
소속 상세정보
김혜진 ( Kim Hye-Jin ) - Pusan National University Yangsan Hospital Department of Anesthesia and Pain Medicine
김소현 ( Kim So-Hyun ) - Pusan National University Yangsan Hospital Department of Anesthesia and Pain Medicine
김태흥 ( Kim Tae-Heung ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
윤지영 ( Yoon Ji-Young ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
김철홍 ( Kim Cheul-Hong ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
김은정 ( Kim Eun-Jung ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
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.
키워드
Difficult Mask Ventilation; Mandibular Reconstruction; Orocutaneous Fistula
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