[Awake intubation using lightwand technique under conscious sedation with remifentanil].
We experienced two cases of difficult airway due to deformities in the oral cavities. The first patient was a 62-year-old woman with a large benign soft palate tumor and the second was a 64-year-old woman with macroglossia secondary to acromegaly. Both patients were evaluated difficult to ventilate via face mask and presenting serious risks for tracheal intubation under general anesthesia. The tracheal intubation was planned using the lightwand (Trachilight) under conscious sedation with continuous administration of remifentanil. Remifentanil (0.1-0.25 microg x kg(-1) x min(-1)) maintained the patients' spontaneous ventilation and increased their tolerance to the pain and discomfort caused by insertion of the lightwand. In both patients, remifentanil mildly suppressed the coughing reflex as well as the autonomic responses to stimuli to the airway. Tracheal intubation was managed successfully in both cases and the operations were completed under general anesthesia. Although the patients were aware of being intubated, they could not recall the procedures postoperatively. The awake intubation technique using the lightwand under conscious sedation with remifentanil can be safely applied to a patient with difficult airway.
Igarashi
Ayuko
A
Department of Anesthesiology, Yamagata Prefectural Shinjo Hospital, Shinjo 996-0025.
Yokoo
Noriko
N
Sato
Masayoshi
M
Amagasa
Sumio
S
D000768:Anesthesia, General; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D008875:Middle Aged; D010880:Piperidines; D000077208:Remifentanil; D014851:Wakefulness
D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil