Case 26: General Anesthesia for a Patient with a Difficult Airway and Full Stomach
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A 26-year-old female (ASA 2E), weight 260 lbs., height 5′6″, and BMI 43, is scheduled for an emergency appendectomy. She has a class 3 airway but tells you that she has a previous history of a traumatic and difficult endotracheal intubation. She is otherwise healthy and takes no medication. She refuses a regional block, as she has a lot of back problems. You decide on a fiber-optic intubation, but you are fully aware that topical anesthesia and sedation must be kept to a minimum in an attempt to maintain the patient’s protective laryngeal reflexes and decrease the likelihood of gastric aspiration.
KeywordsFull stomach General anesthesia Rapid sequence induction Difficult airway Endotracheal tube Position Cricoid pressure Mucosal atomizer device MicroMist nebulizer, Cocaine 4%, Lidocaine 4%
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