title: [A case of impossible ventilation after induction of anesthesia in a patient with massive nasal bleeding].
abstract: We report a case of impossible ventilation in a patient with severe nasal bleeding. A 47-year-old man with intractable nasal bleeding was scheduled for emergent hemostasis under general anesthesia. He also had alcohol-related cirrhosis and was highly obese (165 cm, 93 kg). Although he sufficiently fasted and did not experience nausea in the supine position, we planned crash intubation in the head-elevated position with the Pentax-AWS Airwayscope (AWS) in order to avoid vomiting after induction of anesthesia. After fentanyl, propofol, and rocuronium administration, the patient vomited a large amount of blood, which led to a deterioration of SpO2. Mask ventilatidn was impossible even after oral suctioning. We intubated the trachea with the Macintosh laryngoscope and suctioned blood from the trachea; SpO2 gradually improved and the trachea was washed with a large amount of normal saline. The patient was transferred to the intensive care unit and extubated uneventfully on day 3 postoperatively.
authors: Fumihiro
authors: F
authors: Ohchi
authors: Nobuyasu
authors: N
authors: Komasawa
authors: Noriko
authors: N
authors: Kadono
authors: Toshiaki
authors: T
authors: Minami
mesh_terms: D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged
chemical_list: D018686:Anesthetics, Intravenous