RESUMO
Using a Racz catheter (Brevi-XL™, Epimed Inc., NY, USA) to insert an epidural blood patch (EBP) may be an effective method of reaching the target epidural space in the cervical region. We would like to present a case, wherein a targeted EBP via Racz catheter was used in the management of spontaneous intracranial hypotension. When the leak point is clear via imaging, EBP should be performed exactly at that point. However, if the leak point is unclear, with only a contrast agent pool detected via imaging, EBP should be performed to mask the entire region of the pool. In both cases, EBP via Racz catheter is a convenient and effective method for the management of spontaneous intracranial hypotension. Further cases may be needed to verify our results.
RESUMO
PURPOSE: Intubation and ventilation cannot be performed in cases of parapharyngeal space tumors as the enlargement of the upper airway leads to the obstruction and hindrance of the intubation procedure. However, there is limited literature on anesthetic management, including the airway, in this disease. Herein, we report a successful case of awake intubation in a patient with parapharyngeal space tumor. CASE PRESENTATION: A 64-year-old man with a history of giant parapharyngeal space tumor was scheduled for bilateral endoscopic sinus surgery and nasal septoplasty. We performed awake intubation using the McGrath® video laryngoscope, which resulted in excellent laryngeal deployment and a smooth procedure. CONCLUSION: We report the anesthetic management of a giant parapharyngeal space tumor with the potential for difficult airway management to maintain spontaneous breathing. Awake intubation was useful in maintaining ventilation and intubation in this case. The preparation of a cricothyroid puncture is needed in cases of intubation failure.
