Awake Fiberoptic Nasotracheal Intubation and Anesthetic Management of a Patient With a Compressed and Deviated Airway From a Massive Thyroid Goiter: A Case Report.

清醒纤维鼻气管插管和麻醉管理的患者与压缩和偏离的气道从一个巨大的甲状腺甲状腺肿 ： 病例报告。

• 发表时间: Feb 2023
• 来源期刊: Cureus
• DOI: 10.7759/cureus.35278
• PMID: 36968903
• 文章类型: Case Reports
• 作者列表: Tan D,Zhang X

关键词: awake fiberoptic intubation; difficult airway intubation; difficult airway management; naso endotracheal intubation; tracheal compression; tracheal narrowing

Abstract

Difficult airway management is a challenge for anesthesiologists, requiring proper assessment, planning, and sometimes a multidisciplinary approach to establish a secure airway. Here we present a case where the patient had a large thyroid goiter with significant tracheal compression. Due to the large size of the thyroid mass and the location of tracheal narrowing, fiberoptic intubation appeared to be challenging, and a surgical airway was not a viable option to obtain a secure airway for a total thyroidectomy. This case report discusses awake fiberoptic intubation and intraoperative anesthetic management of a patient with known airway compression and explores the alternative method for obtaining a definitive airway through venovenous extracorporeal membrane oxygenation.

摘要

困难的气道管理是麻醉医师面临的挑战，需要适当的评估，规划,有时是建立安全气道的多学科方法。在这里，我们介绍了一个病例，该患者患有巨大的甲状腺甲状腺肿，并伴有明显的气管压迫。由于甲状腺肿块较大，气管狭窄的位置，光纤插管似乎很有挑战性，手术气道不是获得甲状腺全切除术安全气道的可行选择.本病例报告讨论了已知气道受压患者的清醒光纤插管和术中麻醉管理，并探讨了通过静脉静脉体外膜氧合获得确定气道的替代方法。