title: [Awake insertion of i-gel under dexmedetomidine sedation in a patient with severe obstructive sleep apnea syndrome].
abstract: We report a successful awake insertion of the i-gel supraglottic airway device under dexmedetomidine (DEX) sedation in a patient with severe obstructive sleep apnea syndrome and symptomatic angina. A 71-year-old man was scheduled for open stoma closure under general anesthesia. Given the patient's history of difficult mask ventilation during anesthesia for resection of rectal cancer, we decided to perform awake i-gel insertion under DEX sedation and regional anesthesia with lidocaine. The i-gel was inserted successfully with no vital sign change or vomiting. We also performed transversus abdominis plane block and rectus sheath block with ropivacaine, as severe respiratory suppression due to continuous intravenous fentanyl infusion had been observed in the previous operation. No vital sign change or respiratory suppression was noted upon recovery from general anesthesia. Awake insertion of a supraglottic airway device, such as i-gel, under DEX sedation can be effective for airway management in patients with severe obstructive sleep apnea syndrome.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Matsunami
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kuzukawa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fujitate
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Minami
mesh_terms: D000368:Aged; D000765:Anesthesia, Conduction; D000787:Angina Pectoris / Q000150:complications; D020927:Dexmedetomidine / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000150:complications*
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine