J Korean Dent Soc Anesthesiol.  2013 Jun;13(2):51-54. 10.17245/jkdsa.2013.13.2.51.

Massive Epistaxis during Nasotracheal Intubation

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea. drjack@nate.com

Abstract

A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and wesuccessfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

Keyword

Epistaxis; Hypoxemia; Nasotracheal intubation

MeSH Terms

Adult
Airway Management
Anesthesia, General
Anoxia
Body Mass Index
Body Weight
Epistaxis*
Humans
Intubation*
Laryngoscopy
Mandibular Fractures
Obesity, Morbid
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