Korean J Anesthesiol.  2014 Feb;66(2):157-159. 10.4097/kjae.2014.66.2.157.

An awake double lumen endotracheal tube intubation using the Clarus Video System in a patient with an epiglottic cyst: a case report

• Seo H
• Lee G
• Ha SI
• Song JG

• KMID: 2092437
• DOI: http://doi.org/10.4097/kjae.2014.66.2.157

Abstract

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 microg, 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.

Keyword

Airway obstruction; Difficult intubation; Laryngeal mass

MeSH Terms

Airway Obstruction
Epiglottis
Fentanyl
Glycopyrrolate
Humans
Intubation*
Laryngeal Nerves
Laryngoscopy
Lidocaine
Male
Midazolam
Middle Aged
Oropharynx
Oxygen
Pancreaticoduodenectomy
Recovery Room
Thoracic Surgery, Video-Assisted
Fentanyl
Glycopyrrolate
Lidocaine
Midazolam
Oxygen