Abstract

MURILLO, Marcelino et al. Anesthesia for emergency tracheostomy due to bleeding hemangioma of the tongue in a pregnant patient. Rev. colomb. anestesiol. [online]. 2012, vol.40, n.4, pp.313-317. ISSN 0120-3347.  https://doi.org/10.1016/j.rca.2012.05.015.

We present the case of a 20-year-old pregnant patient diagnosed with cavernous hemangioma in her tongue, lips and neck with active bleeding. An emergency tracheostomy under general anesthesia was scheduled. Anesthesia was planned for conscious intubation with a fibrobronchoscope suited for the difficult airway management ASA algorithms. The airway was managed with a number 5.5 Fr. endotracheal tube under 0.02-0.05µg/kg/min remifentanyl infusion. The patient was sedated and given local anesthesia in the upper airway to reduce pain and gag reflex during spontaneous breathing. Intubation was successful. Having a total blood loss of 200 cc, the patient was taken to the postoperative care room hour after surgery. The airway was managed with a tracheostomy procedure using a number 7.5 Fr tube and without damaging the hemangioma. She was then scheduled for a vessel embolectomy and surgical removal. In this case, conscious intubation with remifentanyl was safe and adequate for the approach of the patient with bleeding airway hemagioma.

Keywords : Hemangioma; Pregnancy; Intubation; Vascular anormalities.

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