Awake Fiberoptic Intubation in a Patient with T4N2M1 Buccal Tumor and Pulmonary Metastasis: A Case Report and Anesthetic Challenges
DOI:
https://doi.org/10.37275/bsm.v9i3.1208Keywords:
Anesthesia, Awake fiberoptic intubation, Buccal cancer, Difficult airway, Lung metastasisAbstract
Background: Advanced buccal cancer with pulmonary metastasis presents significant challenges for airway management due to potential anatomical distortions and respiratory compromise. Awake fiberoptic intubation (AFOI) is often the preferred technique in these cases. This report describes the successful anesthetic management of a patient with a T4N2M1 buccal tumor and lung metastasis using AFOI.
Case presentation: A 64-year-old male with a T4N2M1 buccal tumor and pulmonary metastasis presented for an open biopsy and biopsy of the oral cavity. He had limited mouth opening (Mallampati 2), anemia, and hypoalbuminemia. AFOI was performed using dexmedetomidine and topical lidocaine. General anesthesia was induced with propofol and atracurium and maintained with sevoflurane. Postoperative pain was managed with paracetamol and ketorolac. The patient's recovery was uneventful.
Conclusion: This case highlights the importance of AFOI in securing the airway for patients with advanced buccal cancer and pulmonary metastasis. Meticulous preoperative planning, including optimization of comorbidities and vigilant perioperative monitoring, is essential for successful outcomes in these complex cases.
Authors
- Numbi Akhmadi Teguh1*
- Jeffri Prasetyo Utomo2
- Taufiq Agus Siswagama2
- 1Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Brawijaya/Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia
- 2Consultant in Anesthesiology and Intensive Care, Universitas Brawijaya/Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia
Corresponding author Numbi Akhmadi Teguh — akhmadinumbi6@gmail.com
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