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

Bidur Kumar Baral^1,2, Susumu Ide^1*, Masahiro Uzawa¹, Kenkichi Kiyosawa¹, Hiroyuki Sasaki³, Mikito Kawamata¹

¹Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan.
²Department of Anesthesiology and Critical Care, Norvic International Hospital, Kathmandu, Nepal.
³Department of Radiology, Shinshu University Hospital, Matsumoto, Japan.

DOI: 10.4236/ojanes.2015.59037                

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.

Keywords

Conscious Sedation, Difficult Mask Ventilation, Awake Fiberoptic Intubation

Conflicts of Interest

The authors declare no conflicts of interest.

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