title: Difficult airway management in a patient with severe aortic stenosis, coronary artery disease, and heart failure.
abstract: We report a patient with aortic stenosis, coronary artery disease, and heart failure in whom awake fiberoptic intubation was performed because the patient's mouth opening was insufficient as a result of disc prolapse of the mandibular joint. We planned to perform this procedure during conscious sedation, spontaneous respiration, and with stable hemodynamic parameters (no tachycardia, hypertension, or hypotension). After oral premedication with dikaliumclorazepate, the patient received clonidine. Fiberoptic intubation was performed while the patient breathed spontaneously. Throughout the procedure, no adverse events occurred. Clonidine is a valuable adjunct for conscious sedation and can be used safely for sympathicolysis, even in patients with aortic stenosis.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Evangelisches Krankenhaus Oberhausen - EKO, Germany. Peter.Kulka@ruhr-uni-bochum.de
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kulka
authors.forename: Michael
authors.initials: M
authors.lastname: Tryba
authors.forename: Michael
authors.initials: M
authors.lastname: Zenz
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery; D003000:Clonidine / Q000008:administration & dosage; D016292:Procedural Sedation; D003327:Coronary Disease / Q000150:complications* / Q000601:surgery; D006333:Heart Failure / Q000150:complications*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D014081:Tooth Extraction / Q000009:adverse effects
chemical_list: D003000:Clonidine