2022 Volume 50 Issue 3 Pages 128-130
Robin sequence (RS) is a congenital disease with micrognathia, glossoptosis-caused airway obstruction, and cleft palate as primary symptoms. Pediatric patients with RS are prone to airway obstruction when anesthesia is introduced, and intubation can be difficult because of micrognathia, which is problematic for anesthesia management. We provided general anesthesia management for a glossopexy in a 45-day-old female patient with RS. In this case, mask ventilation after introduction would have been challenging because unless the patient was in the lateral decubitus position during sleep, ventilation would be difficult. Thus, a nasopharyngeal airway was inserted under sedation, and anesthesia was introduced after confirming that the upper airway obstruction had improved. As it was difficult to intubate using a GlideScope® Cobalt (GS) or a Fiberscope (FB) alone, a narrow field of view of the larynx was secured by performing a two-person technique using both a GS and a FB, making intubation feasible. After fixing the tube, the absence of any breathing problems was confirmed, and the patient’s vital signs remained stable. The operation was then started. The patient’s respiratory and vital signs were stable throughout the operation. Postoperatively, the resting SpO2 remained in the high 90% range, the patient’s breathing was stable even in the supine position, and no hypoventilation was noted. Furthermore, under the guidance of a nurse, the patient’s mother was able to feed the infant without difficulty. Hence, the patient was discharged on postoperative day 2.
