Awake Tracheal Intubation sebagai Pendekatan Anestesi pada Pasien dengan Predictive Difficult Airway: Laporan Kasus dari Perspektif Frontliner

Rani Pradnya Swari, Dewa Ngakan Gde Dwija Sanjaya

Abstract


Laporan kasus ini bertujuan meningkatkan kesadaran tentang tantangan risiko dan pengelolaan masalah jalan napas yang sulit di daerah pedesaan dengan kekurangan fasilitas di ruang operasi. Kami melaporkan kasus laki-laki 31 tahun dengan karsinoma sel skuamosa masif di sisi kiri leher yang dikirim untuk eksisi dan drainase tumor. Pasien dinilai dengan status fisik ASA III karena prediksi jalan napas sulit dan suspek septik. Kami mengalami kesulitan untuk meraba sendi temporomandibular dan kekakuan pada leher. Pasien kami intubasi dalam kondisi sadar sepenuhnya dengan beberapa kesulitan karena kekurangan obat dan alat di rumah sakit kami. Pasien diekstubasi dalam kondisi sadar dengan aman setelah proses operasi dan dipindahkan ke ICU.


Keywords


Awake Intubation; kekakuan leher; manajemen jalan napas sulit; sendi temporomandibular tidak teraba

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References


  1. Xue FS, Liu QJ. Tracheal intubation awake or under anesthesia for potential difficult airway : look before you leap. Chin Med J (Engl). 2018;131(6):753–6.
  2. Kostyk P, Francois K, Salik I. Airway anesthesia for awake tracheal intubation: a review of the literature. Cureus. 2021;13(7):1–17.
  3. Roth D, Pace NL, Lee A, Hovhannisyan K, Am W, Arrich J, dkk. Management in apparently normal adult patients (review). Cochrane Library. 2018. 231–233.
  4. Law JA, Broemling N, Cooper RM, Drolet P, Mullen T, Murphy MF, dkk. The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious /induced patient. Can J Anesth. 2013;60:1089–118.
  5. Ahmad I, Bhagrath R, Hodzovic I, Mcnarry AF, Mir F, Sullivan EPO, dkk. Dif fi cult airway society guidelines for awake tracheal intubation (ATI) in adults. Anesthesia. 2020;75:509–28.
  6. Fiadjoe JE, Greif R, Klock PA, Mercier D, Myatra SN, Sullivan EPO, dkk. American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway, 2022.
  7. Boku AS Kuroda I, Imura H, Hashimoto M, Tachi N, Okuda M. Perioperative management of a patient with von recklinghausen ’ s disease with anticipated difficult airway management: a case report. Cureus. 2022;14(2):2–5.
  8. Tagaito Y, Isono S, Tanaka A, Ishikawa T, Nishino T. Sitting posture decreases collapsibility of the passive pharynx in anesthetized paralyzed patients with obstructive sleep apnea. Anesthesiology. 2010;115(4):812–8.
  9. Lim WY, Wong P. Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: a case series and narrative review. Korean J Anesthesiol. 2019;72(6):548–57.
  10. Desai N, Ratnayake G, Onwochei DN, El-boghdadly K, Ahmad I. Airway devices for awake tracheal intubation in adults : a systematic review and network meta-analysis. Br J Anaesth.2021;127(4):636–47.
  11. Moore A, Schricker T. Awake videolaryngoscopy versus fiberoptic bronchoscopy. Wolters Kluwer Heal. 2019;32(6):764–8.
  12. Jiang J, Ma D, Li B, Wu A, Xue F-S. Videolaryngoscopy versus fiberoptic bronchoscope for awake intubation–a systematic review and meta-analysis of randomized controlled trials. Ther Clin Risk Manag. 2018;14:1955–63.
  13. Nishikawa K, Kawana S. Comparison of the lightwand technique with direct laryngoscopy for awake endotracheal intubation in. J Clin Anesth. 2001;8180(01):259–63.
  14. Law JA, Duggan LV, Asselin M, Baker P, Crosby E, Downey A, dkk. Canadian airway focus group updated consensus-based recommendations for management of the difficult airway: part 2. planning and implementing safe management of the patient with an anticipated difficult airway.Can J Anaesth. 2021;68(9):1405–36.
  15. Hadzic A. Penyunting. Regional and topical anesthesia for awake endotracheal intubation. Dalam: HADZIC’S textbook of regional anesthesia and acute pain management. Edisi ke-2. McGraw-Hill Education; 2017. hlm. 289.
  16. El-Boghdadly K, Onwochei DN, Cuddihy J, Ahmad I. A prospective cohort study of awake fibreoptic intubation practice at a tertiary centre. Anesthesia. 2017;72(6):694–703.
  17. Johnston KD, Hons M, Rai MR. Conscious sedation for awake fibreoptic intubation : a review of the literature. Can J Anaesth. 2013;60(6):584–99.
  18. Tang Z, Chen Q, Wang X, Su N, Xia Z, Wang Y. A systematic review and meta-analysis of the safety and ef fi cacy of remifentanil and dexmedetomidine for awake fi beroptic endoscope intubation. Medicine (Baltimore). 2021;100(14):1–7.
  19. Filippini M, Fominskiy E, Pintaudi M, Putzu A, Votta CD, Sorbello M, dkk. Awake fiberoptic intubation protocols in the operating room for anticipated difficult airway: a systematic review and meta-analysis of randomized controlled trials. Int Anesth Reseach Soc.2019;128(5):9–11.
  20. Heidegger T, Schnider T. “Awake” or “sedated”: safe flexible bronchoscopic intubation of the difficult airway. Open Mind. 2017;124(3):2016–7.




DOI: https://doi.org/10.15851/jap.v11n3.3480

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