Anesthesia for emergency tracheostomy due to bleeding hemangioma of the tongue in a pregnant patient
Keywords:
Hemangioma, Pregnancy, Intubation, Vascular anormalitie
Abstract
We present the case of a 20-year-old pregnant patient diagnosed with cavernous hemangioma in her tongue, lips and neck with active bleeding. An emergency tracheostomy under general anesthesia was scheduled. Anesthesia was planned for conscious intubation with a fibrobronchoscope suited for the difficult airway management ASA algorithms. The airway was managed with a number 5.5 Fr. endotracheal tube under 0.02-0.05 |xg/kg/min remifen-tanyl infusion. The patient was sedated and given local anesthesia in the upper airway to reduce pain and gag reflex during spontaneous breathing. Intubation was successful. Having a total blood loss of 200 cc, the patient was taken to the postoperative care room hour after surgery. The airway was managed with a tracheostomy procedure using a number 7.5 Fr tube and without damaging the hemangioma. She was then scheduled for a vessel embolectomy and surgical removal. In this case, conscious intubation with remifentanyl was safe and adequate for the approach of the patient with bleeding airway hemagioma.
References
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2. Bonet C, Mínguez I, Palma C, Galán S, Penarrocha M, Mínguez J. Clinical characteristics, treatment and outcome of 28 oral haemangiomas in pediatric patients. Med Oral Patol Oral Cir Bucal. 2011;16:19-22.
3. Qureshi SS, Chaukar DA, Pathak KA, Sanghvi VD, Sheth T, Merchant NH, et al. Hemangioma of base of tongue. Indian J Cancer. 2004;41:181-3.
4. Vijay K, Shetty A, Rajasekaran S. Symptomatic vertebral hemangioma in pregnancy treated antepartum. A case report with review of literature. Eur Spine J. 2008;17 Suppl 2:S299-303.
5. Tekkók IH, Acikgóz B, Saglam S, Onol B. Vertebral hemangioma symptomatic during pregnancy - Report of a case and review of the literature. Neurosurgery. 1993;32:302-6.
6. Melendez H, Leal D, Ramirez D. Agreement between the objetive and subjetive evaluation for predicting and finding a difficult airway. Rev Colomb Anestesiol. 2010;1:34-49, 38.
7. Pandit JJ. Orotracheal fibreoptic intubation for rapid sequence induction of anesthesia. Anesthesia. 2002;57:123-7.8. Mariscal M, Pindado M, Ortigosa E. Fibrobroncoscopio flexible. En: Pindado M, Mariscal M, editores. Vía aérea difícil. Madrid: Ergon; 2000.
9. Riveros E. Validation of the clinical usefulness of an articulated orotracheal catheter in the operating room and intensive care. Rev Colomb Anestesiol. 2011;39:330-9.
10. Pérez M. Tratamiento de hemangiomas y malformaciones vasculares congénitas de región bucal y peribucal con criocirugía con la técnica de microhisopo utilizando nitrógeno líquido [tesis en Licenciatura]. Guatemala: Universidad Francisco Marroquín, Facultad de Odontología; 1993, 4.
11. Novoa L, Navarro M, Vieito M, Hernandez J, Arxer A, Villalonga A. Analgesia y anestesia obstétrica con remifentanilo a una paciente con enfermedad de von Willebrand. Rev Esp Anestesiol Reanim. 2003;50:242-4.
12. Wang MT, Shue HN, Ho KY, Yu HS, Juan KH, Fang KT. Nasal septal hemangioma of pregnancy. Gaoxiong Yi Xue Ke Xue Za Zhi. 1988;4(7):426-30.
13. Kiroglu Y, Benek B, Yagci B, Cirak B, Tahta K. Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy. Surg Neurol. 2009;71:487-92.
14. Noorizan Y, Salina H. Nasal septal haemangioma in pregnancy. Med J Malaysia. 2010;65:70-1.
15. Gottlieb K, Coff P, Preiksaitis H, Juviler A, Fern P. Massive hemorrhage in pregnancy caused by a diffuse cavernous hemangioma of the rectum - EUS as imaging modality of choice. Medscape J Med. 2008;10(9):206.
16. Fuentes R, Sebastianes M, Martínez E, Guerrero M, Torres L. Remifentanilo y cirugía no obstétrica durante el embarazo. Dol Clin Ter. 2005;3:11-2.
17. Bocanegra J, Rios A, Aquirre O. Rigid fiberscope intubation of a patient awake with remifentanil sedation. Rev Colomb Anestesiol. 2010;3:38, 395-401.
18. Costa J, Carvalho D, De Oliveira J, Barrozo A, Santos G. Anestesia venosa total para laringectomía parcial em paciente na 28a semana de gestacáo. Relato de caso. Rev Bras Anestesiol. 2005;55:217-23.
19. Hill D. Remifentanil in obstetrics. Curr Opin Anaesthesiol. 2008;21:270-4.
20. Tasker J, Geoghegan J. Giant cavernous haemangioma of the tongue. Anaesthesia. 2005;60(10):1043.21. Montero FI, Giménez I, Valentí P, Aguilar JL. Vía aérea difícil en paciente con hemangioma gigante de lengua. Rev Esp Anestesiol Reanim. 2008;55(2):131.
22. Mariscal ML, Pindado ML, Rey F, Arrasola B, Engel W. Valoración y predicción de la vía aérea difícil. 2012 [consultado 27 Abr 2012] Disponible en: http://www.arydol.es/valoracion-prediccion-via-aerea-dificil.php.
How to Cite
1.
Murillo M, Zarza M, Gómez S, Chica J, Carrasquilla R, De la Vega J, et al. Anesthesia for emergency tracheostomy due to bleeding hemangioma of the tongue in a pregnant patient. Colomb. J. Anesthesiol. [Internet]. 2012 Oct. 1 [cited 2024 Apr. 25];40(4):313–317. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/777
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Published
2012-10-01
How to Cite
1.
Murillo M, Zarza M, Gómez S, Chica J, Carrasquilla R, De la Vega J, et al. Anesthesia for emergency tracheostomy due to bleeding hemangioma of the tongue in a pregnant patient. Colomb. J. Anesthesiol. [Internet]. 2012 Oct. 1 [cited 2024 Apr. 25];40(4):313–317. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/777
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Section
Case Report / Case Series
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