D'Souza Avinash, Shenoy Priyanka, Nolasco Andrew, Schlesinger Mark
Anesthesiology, Hackensack University Medical Center, Hackensack, USA.
Cureus. 2025 Jun 21;17(6):e86504. doi: 10.7759/cureus.86504. eCollection 2025 Jun.
Management of difficult airways is a recognized challenge in anesthesia and can be further complicated by altered anatomy. We present a case of a 56-year-old male with a history of a mandibular jaw tumor resection requiring coronary artery bypass graft (CABG) surgery. The altered anatomy due to the patient's jaw resection required awake intranasal fiberoptic intubation as there was limited oral access. Our discussion focuses specifically on adequate pre-induction preparation, hemodynamic monitoring, and pharmacological agents used for intubation. Despite the complexity of the case, our patient was successfully induced and intubated without any adverse outcomes. He ultimately underwent a two-vessel CABG with uneventful extubation.
困难气道的管理是麻醉领域公认的一项挑战，而解剖结构改变会使其进一步复杂化。我们报告一例56岁男性患者，有下颌骨肿瘤切除病史，需要进行冠状动脉旁路移植术（CABG）。由于患者下颌骨切除导致解剖结构改变，口腔通路受限，因此需要清醒状态下经鼻纤维支气管镜插管。我们的讨论特别关注充分的诱导前准备、血流动力学监测以及用于插管的药物。尽管该病例复杂，但我们的患者成功诱导并插管，未出现任何不良后果。他最终接受了双支血管CABG，拔管过程顺利。
