Author/Authors :
Stevic, Marija Zvezdara University - Center Belgrade - Department of Anesthesia, Serbia , Bokun, Zlatko Zvezdara University - Center Belgrade - Department of Minimally Invasive Surgery, Serbia , Milojevic, Irina Zvezdara University - Center Belgrade - Department of Anesthesia, Serbia , Budic, Ivana University of Nis - Faculty of Medicine, Clinical Centre Nis - Department of Anesthesia, Serbia , Jovanovic, Branislav Zvezdara University - Center Belgrade - Department of Pediatric Surgery, Serbia , Krstic, Zoran University of Belgrade - Faculty of Medicine - Department of Pediatric Surgery, Serbia , Simic, Dusica University of Belgrade - Faculty of Medicine - Department of Anesthesia, Serbia
Abstract :
Objective: The aim of this paper was to report the management of anesthesia of a child with a large neck rhabdoid tumor. Clinical Presentation and Intervention: A 9-monthold female patient underwent urgent neck tumor excision due to intratumoral bleeding from a large tumor that compressed and dislocated the trachea; therefore, intubation was expected to be difficult. Sevoflurane inhalation induction was utilized to maintain spontaneous respiration. Oral laryngoscopy revealed Cormack-Lehane grade 3 laryngeal view. The trachea was intubated using a reinforced tube on the third attempt. Fiberoptic bronchoscope-assisted intubation was planned as an alternative in case of conventional intubation failure. Anticipation of massive blood loss necessitated central venous catheterization. Conclusion: Establishing a safe airway, intubation during spontaneous breathing and invasive hemodynamic monitoring are crucial factors in the anesthetic management of pediatric patients with a large neck tumor.
