AWAKE FIBER OPTIC INTUBATION IN A PATIENT OF POST COMBINED MANDIBULECTOMY AND NECK DISSECTION OPERATION.

Dr. Monal Ramani, Dr. Siddharth Parmar, Dr. Ritu Ruparel, Dr. Prachi Agnihotri

Abstract


Combined mandibulectomy and neck dissection operation is an procedure for malignant tumors of floor of oral cavity which
involves partial removal of mandible , floor of mouth and/or tongue accompanied by radical neck dissection which creates very
difficult airway for these patients for any subsequent surgeries. We report a case of 52 year male patient posted for left
PCNL(Percutaneous Nephrolithotomy) surgery for renal stone, who was previously operated for left sided Combined
mandibulectomy and neck dissection operation procedure for oral cancer under general anesthesia. After thorough preoperative
preparation fiberoptic intubation was done successfully in this spontaneously breathing awake patient under topical anesthesia,
correct endotracheal placement of tube was checked and intravenous anesthetics were given . Patient was successfully
extubated after regaining of proper respiratory efforts and fully awake state.


Keywords


Awake intubation, difficult intubation, topical anaesthesia, distorted facial anatomy, psychological preparation

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References


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