Articles Vol. 65 No. CĐ 9 - Hội Gây mê Hồi sức 26/09/2024

12. CASE REPORT OF SUCCESSFUL PERFORMANCE FOR ENDOTRACHEAL INTUBATION AND EXTUBATION IN A COMLICATED MAXILLOFACIAL CANCER SURGERY WITH FREE FLAP RECONSTRUCTION

Dao Thi Kim Dung1,2, Phi Thi Hoa1,2
1 Viet Duc University Hospital
2 Bệnh viện Hữu nghị Việt Đức
Corresponding author: kimdung.vietduc@gmail.com
DOI: 10.52163/yhc.v65iCD9.1521
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Keywords
Difficult airway managemen difficult intubation difficult extubation
Abstract

Airway management of the patient maxillectomy with free flap reconstruction is unique challenges for anesthetic. To ensure safety, a clear strategy, collaborative approach and effect is essential.

Maxillofacial cancer causes major changes in the anatomy of the upper respiratory, making it difficult to intubation and extubation. In particular, extubation is difficult, risks and complications. Tracheostomy is often chosen after major maxillofacial cancer sugery. However, tracheostomy also has many risks: swallowing function, tracheal stenosis… affects quality of life. Also, consider between tracheostomy immediately after surgery and delaying, evaluating extubation when qualified, to avoid tracheostomy.

This is a case of difficult intubation and extubation in the patient with maxillofacial cancer at the Department of Anesthesiology 2, Viet Duc Unisversity Hospital.

References
[1]
Cook TM, Woodall N, Frerk C, Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth Google Scholar
[2]
National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society, Part 1: anaesthesia, Br J Anaesth, 2011, 106(5): Google Scholar
[3]
-631, doi:10.1093/bja/aer058. Google Scholar
[4]
Schmutz A, Dieterich R, Kalbhenn J, Voss P, Loop T, Heinrich S, Protocol based evaluation for feasibility of extubation compared to clinical scoring systems after major oral cancer surgery safely reduces the need for tracheostomy: a retrospective cohort study, BMC Anesthesiol, 2018, 18:43, doi:10.1186/s12871-018-0506-8. Google Scholar
[5]
Sidhu VS, Whitehead EM, Ainsworth QP, Smith M, Calder I, A technique of awake fibreoptic intubation. Experience in patients with cervical spine disease, Anaesthesia, 1993, 48(10):910-913, doi:10.1111/j.1365-2044.1993.tb07429.x. Google Scholar
[6]
News A, Unplanned or Accidental Extubation in the Perioperative Environment, Accessed July 27, 2024, https://www.AnesthesiologyNews.com/Review-Articles/Article/08-19/Unplanned-or-Accidental-Extubation-in-the-Perioperative-Environment/55658?ses=ogst. Google Scholar
[7]
Rothaar RC, Epstein SK, Extubation failure: magnitude of the problem, impact on outcomes, and prevention, Curr Opin Crit Care, 2003, 9(1): 59-66, doi:10.1097/00075198-200302000-00011. Google Scholar
[8]
Joffe AM, Aziz MF, Posner KL, Duggan LV, Mincer SL, Domino KB, Management of Difficult Tracheal Intubation: A Closed Claims Analysis., Anesthesiology, 2019, 131(4): 818-829, doi:10.1097/ALN.0000000000002815. Google Scholar
[9]
Apfelbaum JL, Hagberg CA, Connis RT et al, American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Google Scholar
[10]
Airway, Anesthesiology, 2022, 136(1): 31-81, doi:10.1097/ALN.0000000000004002. Google Scholar
[11]
Law JA, Duggan LV, Asselin M et al, Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2, Planning and implementing safe management of the patient with an anticipated difficult airway, Can J Anaesth J Can Google Scholar
[12]
Anesth, 2021, 68(9): 1405-1436, doi:10.1007/s12630-021-02008-z. Google Scholar
[13]
DAS Guidelines Home | Difficult Airway Society, Accessed July 27, 2024, https://das.uk.com/guidelines. Google Scholar