Use of remifentanil for awake fiberoptic intubation in a morbidly obese patient with severe inflammation of the neck

Authors: Puchner W.¹; Obwegeser J.²; Pühringer F.K.³

Source: Acta Anaesthesiologica Scandinavica, Volume 46, Number 4, April 2002 , pp. 473-476(4)

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Abstract:

Impending upper airway obstruction due to odontogenic facial and cervical spreading infection is a potential fatal situation that requires urgent treatment. In particular, securing the threatened airway is a priority and a precondition to the pressing need for surgery. The best approach to establish the difficult airway is awake fiberoptic intubation or scheduled tracheotomy under local anesthesia. We report a critical case of severe swelling of the neck in a morbidly obese patient with no alternative to awake fiberoptic intubation. The primary goals of optimal safety for the patient and appropriate intubating conditions for the anesthesiologist made us to consider a new method of patient medication.

Keywords: awake fiberoptic intubation; difficult airway; morbid obesity; odontogenic infection; remifentanil; upper airway obstruction

Language: English

Document Type: Original article

DOI: http://dx.doi.org/10.1034/j.1399-6576.2002.460426.x

Affiliations: 1: Department of Anesthesia and Intensive Care Medicine, and 2: Department of Oral and Maxillo-Facial Surgery, General Hospital Linz, Linz, Austria 3: Department of Anesthesia and Intensive Care Medicine, Kreiskliniken Reutlingen, Reutlingen, Germany

Publication date: 2002-04-01