Anaesthetic concerns of difficult airway in case of large oral hemangioma posted for robotic cystectomy

A difficult airway poses a challenge to attending anaesthesiologist. Fibreoptic intubation (FOI) to secure airway can be a valuable option in such a scenario. Steep Trendelenberg’s position with pneumoperitoneum in robotic surgery causes respiratory changes with airway oedema and congestion. We are describing here a case report of 56-year male patient with a large congenital oral cavity hemangioma with primary urothelial neoplasm of bladder posted for robotic radical cystectomy with ileal conduit with urethrectomy. We emphasize the importance of difficult airway management by using fibre optic technique in such cases complicated by steep Trendelenburg’s position required during robotic surgeries.

Inappropriate fixation of an endotracheal tube causing cuff malfunction resulting in difficult extubation / Fixação inadequada de tubo endotraqueal, resultando em mau funcionamento do manguito e extubação difícil

Abstract We discuss a case of difficult extubation, due to inadequate deflation of the tracheal tube cuff, despite collapse of the pilot balloon, on its aspiration. This was caused by inadvertent kinking of the pilot balloon tubing due to inappropriate tape fixation of the endotracheal tube.

Resumo Relatamos o caso de extubação difícil devido à desinsuflação inadequada do cuff do tubo traqueal, a despeito do colapso do balão piloto, em sua aspiração. Isso foi causado pela torção inadvertida do tubo com balão piloto devido à fixação inadequado do tubo endotraqueal com fita adesiva.

A case of Difficult Tracheal Extubation of an Armoured Endotracheal Tube.

Use of repeatedly ETO sterilized armoured endotracheal tube is routine practice in our set up. Hereby we discuss a case of difficult tracheal extubation following prolonged intubation i.e. 11 hours for neuro surgical operation. The details of the procedure and causes are discussed.

Difficult Extubation of Endotracheal Tube: Two case reports / 대한마취과학회지

The problem of difficult intubation is well known to anesthesiologists. However, difficulties associated with the extubation of endotracheal tubes are not common, and few reports exist. However, untoward incidents of diverse etiology can occur and the complications of difficult extubation may be fatal. We experienced 2 cases of difficult extubations. One was due to adhesion of the tube to the tracheal wall and the other was due to a fold in the deflated cuff of an excessively large-sized tube. We managed these difficult extubations by rotating the tube with a MaGill forcep under direct laryngoscopy. We report upon these clinical experiences and include a brief review of the literature.