Adelia Handoko
Department Physiology, Faculty of Medicine, University of Jember

Muhammad Irsyad Amien
Student of Faculty of Medicine, University of Jember–Dr. Soebandi Jember, Indonesia

Nurrul Izza Misturiansyah
Student of Faculty of Medicine, University of Jember–Dr. Soebandi Jember, Indonesia

Muhamad Rizal Hadi Pratama
Internship Doctor of Mojowarno Hospital Jombang, Indonesia

DOI: https://doi.org/10.19184/ams.v9i3.41778

Abstract

When dealing with clinical disorders known as difficult airways, airway management during general anesthesia is still a challenge. A cross-sectional study held in Indonesia in 2016 found that 28 out of 250 patients in general anesthesia have had respiratory problems. A proper and effective management should resolve this issue. This case report described a 14-month-old patient with right preauricular lymphoma was planned to do tumor biopsy surgery under general anesthesia. The size of the tumor mass was large enough to covered the patient's airway and made these difficult to manage under general anesthesia, and also made intubation impossible. To resolve it, General Anesthesia trough bag and mask was modified by of reverse position during anesthesia and procedure. Procedure was safely done and the patient was discharged shortly after it. Appropriate management during perioperative especially related to airway management determined patient outcome and safety. This case report hopefully could add knowledge and an alternative ventilation technique if you encounter a similar case.

Keyword: Difficult airway, general anesthesia, lymphoma preauricular.

REFERENCE

1. Ahmad, I., D. N. Onwochei, S. Muldoon, O. Keane, and K. El-Boghdadly. 2019. Airway management research: a systematic review. Anaesthesia. 74(2):225–236.

2. Apfelbaum, J. L., C. A. Hagberg, R. T. Connis, B. B. Abdelmalak, M. Agarkar, R. P. Dutton, J. E. Fiadjoe, R. Greif, P. A. Klock, D. Mercier, S. N. Myatra, E. P. O’Sullivan, W. H. Rosenblatt, M. Sorbello, and A. Tung. 2022. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. 1. Anesthesiology.

3. Bindu, B., A. Bindra, and G. Rath. 2017. Effect of intravenous dexmedetomidine administered as bolus or as bolus-plus-infusion on subarachnoid anesthesia with hyperbaric bupivacaine. Journal of Anaesthesiology Clinical Pharmacology. 33(3):306–316.

4. Butterworth, J. F., D. C. Mackey, and J. D. Wasnick. 2018. Clinical Anesthesiology. Edisi 6th. New York: Mc Graw Hill Education.

5. Checketts, M. R., R. Alladi, K. Ferguson, L. Gemmell, J. M. Handy, A. A. Klein, N. J. Love, U. Misra, C. Morris, M. H. Nathanson, G. E. Rodney, R. Verma, and J. J. Pandit. 2016. Recommendations for standards of monitoring during anaesthesia and recovery 2015: association of anaesthetists of great britain and ireland. Anaesthesia. 71(1):85–93.