Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942006000600010
Brazilian Journal of Anesthesiology
Clinical Information

Uso da abordagem lateral para introdução de máscara laríngea durante craniotomia em paciente acordado: relato de caso

Use of the lateral approach for laryngeal mask insertion during awake craniotomy: case report

Mirna Bastos Marques; Carlos Henrique Vianna de Castro; Dener Augusto Diniz; Ana Tereza Moreira Dantas de Andrade Pinto; Marcello Penholate Faria

http://dx.doi.org/10.1590/S0034-70942006000600010 Braz J Anesthesiol, vol.56, n6, p.654-657, 2006
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Resumo

JUSTIFICATIVA E OBJETIVOS: Durante uma craniotomia em que se realiza o teste de Afasia de Aachen com o paciente acordado e cooperativo, é necessário o uso da técnica anestésica "dormindo-acordado-dormindo". O objetivo deste relato de caso foi descrever a técnica anestésica utilizada em paciente com sinais de via aérea difícil. RELATO DO CASO: Descreveu-se o caso de um paciente submetido à ressecção de um tumor no lobo temporal esquerdo, no giro de Wernicke, com sinais clínicos de via aérea difícil. Foi utilizada a técnica "dormindo-acordado-dormindo", com infusão contínua de propofol e remifentanil. A via aérea foi mantida com o uso da máscara laríngea, por abordagem lateral. CONCLUSÕES: A técnica utilizada foi eficaz para a obtenção de um paciente acordado e cooperativo no intra-operatório, tendo sido assegurada permeabilidade da via aérea com o uso da máscara laríngea. A inserção desse dispositivo por abordagem lateral é de especial interesse por se tratar de um paciente com possível dificuldade de acesso à via aérea, em procedimento cirúrgico em que era necessário evitar deslocamento do paciente e contaminação do campo cirúrgico.

Palavras-chave

ANESTÉSICOS, Venoso, ANESTÉSICOS, Venoso, ANESTÉSICOS, Venoso, ANESTÉSICOS, Venoso, CIRURGIA, Neurocirurgia, EQUIPAMENTOS, Máscara laríngea

Abstract

BACKGROUND AND OBJECTIVES: During an awake craniotomy in which the Aachen Aphasia test is performed, it is necessary to use the "asleep-awake-asleep" anesthetic technique. The objective of this case report was to describe the anesthetic technique used in a patient with signs of difficult airway. CASE REPORT: The case of a patient who underwent resection of a tumor in the left temporal lobe, in the Wernicke gyrus, with clinical signs of difficult airway is reported. The "asleep-awake-asleep" anesthetic technique, with continuous infusion of propofol and remifentanil, was used. A laryngeal mask, inserted by the lateral approach, was used to keep the airways patency. CONCLUSIONS: The technique used was effective in obtaining an intraoperative awake and cooperative patient, and the airways were maintained patent with a laryngeal mask. Insertion of this device by the lateral approach is especially interesting since this was a patient who presented difficult airway and underwent a surgical procedure in which in which the patient must remain immobile and the surgical field cannot be contaminated.

Keywords

ANESTHETICHS, Intravenous, ANESTHETICHS, Intravenous, ANESTHETICHS, Intravenous, ANESTHETICHS, Intravenous, EQUIPMENT, SURGERY, Neurosurgery

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