Known difficult airway in a patient with pheochromocytoma: a case report

• Published in: Journal of clinical anesthesia Vol. 35; pp. 411 - 414
• Main Authors: Guardo, Laura Alonso, MD, Gala, Carlos Cano, MD, Calvo, Antonio Rodriguez, PhD, Aguirre, Adriana M. Buritica, MD, Arango, Nadia A. Dávila, MD, Fernández, Elena García, MD, Chirosa, Carmen Ruiz, MD, Poveda, David Sánchez, MD, Álvarez, Agustín Díaz, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2016; Elsevier Limited
• Subjects: Adrenal Gland Neoplasms - surgery; Anesthesia; Anesthesia & Perioperative Care; Cardiac arrhythmia; Case reports; Dexmedetomidine; Difficult airway; Dopamine; Humans; Hypertension; Hypnotics and Sedatives; Intubation; Intubation, Intratracheal - methods; Laparoscopy; Male; Medical personnel; Middle Aged; Pain Medicine; Patients; Pheochromocytoma; Pheochromocytoma - surgery; Surgery; Treatment Outcome; Pheochromocytoma; Difficult airway; Dexmedetomidine
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2016.08.034

Abstract The manipulation of an airway is always a critical moment in the anesthetic management of patients with pheochromocytoma due to the high incidence of undesirable hemodynamic events in relation with the stimulus represented by the laryngoscopy. A known difficult airway in which it is necessary to carry out an orotracheal intubation while preserving spontaneous ventilation subjects the patient to a stressful situation. The objective is to obtain an acceptable level of comfort and sedation avoiding respiratory depression ( Anesthesiol Clin 2015;33:233-40). In this case, we describe the management of a known difficult airway in a patient with a pheochromocytoma and a personal history of arterial hypertension and chronic obstructive pulmonary disease who underwent orotracheal intubation with spontaneous ventilation with Airtraq and with dexmedetomidine as the only sedative agent. Conclusion Dexmedetomidine is a useful drug for sedation during orotracheal intubation with spontaneous ventilation in a patient with pheochromocytoma and a chronic respiratory pathology ( Chin Med J (Engl) 2015;128:3143-3148, J Clin Anesth 2007; 19:370-373).