Editorial Type:
Article Category: Brief Report
 | 
Online Publication Date: Dec 15, 2021

A Case of Nasal Mucosa Cautery With Reintubation Under Pharyngeal Suction for Massive Epistaxis After Extubation

DDS, PhD,
DDS,
DDS,
DDS,
DDS, PhD,
DDS, PhD,
DDS, PhD, and
DDS, PhD
Page Range: 235 – 237
DOI: 10.2344/anpr-68-03-04
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We describe a case of massive epistaxis that occurred after removal of a nasal endotracheal tube, prompting emergent reintubation. Mask ventilation could not be performed because the nasal cavity was packed with gauze and the airway was being evacuated with a suction catheter. Therefore, instead of inhalational anesthetics and muscle relaxants, boluses of midazolam and remifentanil were administered, and reintubation was promptly performed. Sedation was maintained with dexmedetomidine infusion and midazolam. Nasal cautery was performed near the left sphenopalatine foramen. The patient was extubated without agitation or additional hemorrhage. Immediate recognition of the potential for airway loss, sufficient control of active bleeding, and drug selection in accordance with the emergent circumstances enabled prompt resecuring of the airway without pulmonary aspiration of blood.

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Copyright: © 2021 by the American Dental Society of Anesthesiology

Contributor Notes

Address correspondence to Dr Yukiko Arai, Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka, 540-0008, Japan; arai-y@cc.osaka-dent.ac.jp.
Received: Jun 09, 2020
Accepted: Aug 20, 2020