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, Gala, Carlos Cano, Calvo, Antonio Rodriguez, Aguirre, Adriana M. Buritica, Arango, Nadia A. Dávila, Fernández, Elena García, Chirosa, Carmen Ruiz, Poveda, David Sánchez, Álvarez, Agustín Díaz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2016; Elsevier Limited
• Subjects: Adrenal Gland Neoplasms - surgery; Anesthesia; 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

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. 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). •Pheochromocytoma and known difficult airway represent a challenge for the anesthesiologist.•Dexmedetomidine can be used for sedation without affecting the ventilatory function.•Dexmedetomidine is useful for sedation during awake endotracheal intubation in a patient with pheochromocytoma.