• Hye-Jin Kim, So-Hyun Kim, Tae-Heung Kim, Ji-Young Yoon, Cheul-Hong Kim, and Eun-Jung Kim.
• Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
• J Dent Anesth Pain Med. 2017 Dec 1; 17 (4): 313-316.

AbstractMask 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.

2 keywords...

hide…