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KMID : 0356920140660020157
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Korean Journal of Anesthesiology
2014 Volume.66 No. 2 p.157 ~ p.159
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An awake double lumen endotracheal tube intubation using the Clarus Video System in a patient with an epiglottic cyst: a case report
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Seo Hyung-Seok
Lee Gunn
Ha Seung-Il
Song Jun-Gol
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Abstract
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A 54-year-old male patient was scheduled for an elective pylorus-preserving pancreaticoduodenectomy combined with video-assisted thoracic surgery at our hospital. This patient had a history of intubation failure in other institutions due to an epiglottic cyst. An airway assessment of the patient was normal. A preoperative laryngoscopy revealed a bulging epiglottic mass covering most of the epiglottis and occupying most of the pharyngeal space. The patient was administered intravenous midazolam 1 mg, fentanyl 50 μg, and glycopyrrolate 0.2 mg. A bilateral superior laryngeal nerve block was then performed with 2% lidocaine 2 ml on each side. A 10% lidocaine spray was applied on to the oropharynx. After preoxygenation with 100% oxygen over 10 minutes, a rigid fiberscope with an optical stylet loaded with a 37 Fr double lumen endotracheal tube was inserted orally and passed into the glottic aperture. The patient was fully awakened after surgical procedure and was transferred to the recovery room after extubation.
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KEYWORD
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Airway obstruction, Difficult intubation, Laryngeal mass
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