title: [Anesthetic Management of an Infant who Underwent Awake-intubation for Her Pharyngeal Injury Caused by a Toothbrush].
abstract: A 2-year-and-4-month-old female infant, 12 kg in weight and 90 cm in height fell off from a table, which was about 1 m height with a toothbrush in her mouth without her parents noticing. Urgent CT scan showed that it penetrated the left side of her oropharyngeal wall to the bifurcation of her right carotid artery. According to the initial assessment, carotid artery seemed intact and there seemed to be no sign of CNS involvement. She underwent general anesthesia for further investigation and operation. We could detect vocal code with ease by inserting Glidescope between her tongue and the toothbrush. After the intubation, we administered fentanyl 25 μg rocuronium 15 mg and sevoflulane 3-5% to her, and then she underwent arteriography. The neurosurgeon found no sign of major arterial injury nor traumatic aneurysm nor CNS involvement. She went to the ICU intubated after the removal of the toothbrush. She was extubated 5 days after operation. One of the benefits of the Glidescope is that we can share the visual image, and we chose it this time. When we expect a difficult airway during management for oropharyngeal trauma, we have to consider the way to manage the airway.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takero
authors.initials: T
authors.lastname: Arai
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Okuda
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D009960:Oropharynx / Q000293:injuries*; D014851:Wakefulness