AWAKE FIBEROPTIC INTUBATION WITH SAYGO APPROACH ON A PATIENT WITH SEVERE ANTERIOR MENTOSTERNAL CONTRACTURE (ONAH TYPE III) UNDERGOING RECONSTRUCTION SURGERY
DOI:
https://doi.org/10.31004/prepotif.v8i2.30091Keywords:
AFOI, Contracture, Intubation, ONAH, SAYGOAbstract
Penelitian ini bertujuan untuk mengevaluasi efektivitas teknik intubasi fiberoptik pada pasien terjaga (Awake Fiberoptic Intubation, AFOI) dalam manajemen jalan napas pada pasien dengan kontraktur leher parah akibat jaringan parut pasca luka bakar. Penelitian ini menggunakan desain studi kasus deskriptif untuk menggambarkan secara rinci manajemen anestesi dan intervensi bedah pada pasien dengan kontraktur leher parah akibat jaringan parut pasca luka bakar. Subjek penelitian adalah pria berusia 35 tahun dengan riwayat luka bakar yang menyebabkan kontraktur leher dan deformitas sekunder pada wajah. Data dikumpulkan melalui pemeriksaan fisik, evaluasi radiografi, dan penilaian menggunakan kriteria seperti MOANS, LEMON, RODS, dan SMART untuk menilai tantangan yang dihadapi pasien. Data terkait manajemen anestesi, proses intubasi, dan intervensi bedah dicatat secara rinci selama operasi, termasuk tanda vital, pemberian obat, dan hasil intraoperatif. Data yang terkumpul akan dianalisis secara deskriptif untuk menggambarkan kondisi klinis pasien sebelum dan sesudah intervensi, serta untuk mengevaluasi efektivitas prosedur anestesi dan bedah yang dilakukan. Hasil analisis akan disajikan dalam bentuk naratif, didukung oleh gambar klinis preoperatif, evaluasi radiografi, dan hasil postoperatif. Hasil penelitian menunjukan bahwa berbagai tes dapat memprediksi jalan napas sulit, dan kasus ini dapat dikelola sesuai pedoman ASA. Teknik AFOI, yang mencakup premedikasi, anestesi lokal, dan sedasi, memiliki tingkat keberhasilan tinggi dan risiko komplikasi rendah. Topikalisasi yang tepat dan infus dexmedetomidine efektif menumpulkan refleks jalan napas dan menjaga stabilitas hemodinamik. Dalam kasus ini, AFOI berhasil dilakukan melalui lubang hidung kiri dengan pasien tetap tenang, terjaga, dan kooperatif.References
Agarwal, R., Dhar, M., & Banerjee, A. (2021). Airway Management in Pediatric Facial Burn Contracture: Safety, Innovation, and Expertise. Journal of Medical Sciences, 41(4), 211. https://doi.org/10.4103/jmedsci.jmedsci_173_20
Apfelbaum, J. L., Hagberg, C. A., Connis, R. T., Abdelmalak, B. B., Agarkar, M., Dutton, R. P., Fiadjoe, J. E., Greif, R., Klock, P. A., Mercier, D., Myatra, S. N., O’Sullivan, E. P., Rosenblatt, W. H., Sorbello, M., & Tung, A. (2022). 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology, 136(1), 31–81. https://doi.org/10.1097/ALN.0000000000004002
Bhatnagar, A., & Singh, A. (2020). The postburn severe flexion contracture neck correction with split-thickness skin graft: Our experience. Indian Journal of Burns, 28(1), 36. https://doi.org/10.4103/ijb.ijb_12_20
Brown, C. A., Sakles, J. C., Mick, N. W., Mosier, J. M., & Braude, D. A. (2022). The Walls Manual of Emergency Airway Management. Lippincott Williams & Wilkins.
Cabrini, L., Baiardo Redaelli, M., Ball, L., Filippini, M., Fominskiy, E., Pintaudi, M., Putzu, A., Votta, C. D., Sorbello, M., Antonelli, M., Landoni, G., Pelosi, P., & Zangrillo, A. (2019). Awake Fiberoptic Intubation Protocols in the Operating Room for Anticipated Difficult Airway: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesthesia & Analgesia, 128(5), 971. https://doi.org/10.1213/ANE.0000000000004087
Dhua, S., & Raheel, S. (2022). Improvement in functional and aesthetic outcome in postburn contracture of neck following split skin grafting using goniometer. Indian Journal of Burns, 30(1), 24. https://doi.org/10.4103/ijb.ijb_12_22
Groombridge, C. J., Maini, A., Johnny, C., McCreary, D., Kim, Y., Smit, D. V., & Fitzgerald, M. (2022). Randomised controlled trial in cadavers investigating methods for intubation via a supraglottic airway device: Comparison of flexible airway scope guided versus a retrograde technique. Emergency Medicine Australasia, 34(3), 411–416. https://doi.org/10.1111/1742-6723.13908
Jain, M., Kiran, S., Bhardwaj, M., Aeron, N., & Singh, A. K. (2024). Effect of supine and upright position on Mallampati grading in predicting difficult laryngoscopy and intubation: A prospective, observational study. Bali Journal of Anesthesiology, 8(1), 40. https://doi.org/10.4103/bjoa.bjoa_258_23
Jung, H. (2023). A comprehensive review of difficult airway management strategies for patient safety. Anesthesia and Pain Medicine, 18(4), 331–339. https://doi.org/10.17085/apm.23123
Kamal, K., Rani, D., Ahlawat, G., & Bansal, T. (2023). Prediction of Difficult Endotracheal Intubation by Different Bedside Tests: An Observational Study. Bali Journal of Anesthesiology, 7(1), 8. https://doi.org/10.4103/bjoa.bjoa_228_22
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Ferdinand Ferry, Otniel Adrians Labobar, Marilaeta Cindryani Ra Ratumasa, Tjokorda Gde Agung Senapathi
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
