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<p>A difficult airway poses significant challenges in anesthesia, requiring expertise and guideline adherence. This report examines airway management in transoral robotic surgery (TORS) for a patient with prior head and neck interventions. A 69-year-old female with tongue carcinoma, prior surgery, radiotherapy, and comorbidities underwent TORS with mandibulectomy and flap reconstruction. Preoperative assessment indicated a high-risk airway, managed with awake fiberoptic intubation using remifentanil for induction and maintenance, supplemented by an inhalational agent and BIS monitoring. She recovered smoothly, with preserved airway reflexes and stable hemodynamics. Comprehensive preoperative evaluation and tailored remifentanil—based analgesia optimized outcomes, highlighting their efficacy in complex airway cases, though further studies are warranted.</p>

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Better Perioperative Airway Management with Remifentanil in Trans-Oral Robotic Surgery for a Patient with Compromised Airway: A Case Report

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Srikanth Tanjore,
  • Anand Murugesan,
  • Naveen Hedne,
  • Joseph Williams,
  • Pavithra Shanmugam,
  • Prethiv Raj Mohan,
  • Sinduja Vairamuthu

摘要

A difficult airway poses significant challenges in anesthesia, requiring expertise and guideline adherence. This report examines airway management in transoral robotic surgery (TORS) for a patient with prior head and neck interventions. A 69-year-old female with tongue carcinoma, prior surgery, radiotherapy, and comorbidities underwent TORS with mandibulectomy and flap reconstruction. Preoperative assessment indicated a high-risk airway, managed with awake fiberoptic intubation using remifentanil for induction and maintenance, supplemented by an inhalational agent and BIS monitoring. She recovered smoothly, with preserved airway reflexes and stable hemodynamics. Comprehensive preoperative evaluation and tailored remifentanil—based analgesia optimized outcomes, highlighting their efficacy in complex airway cases, though further studies are warranted.