術後瘢痕による口唇開閉不能患者の全身麻酔経験

Airway maintenance during oral surgery can be difficult for patients with trismus, tumors in the head and neck region or oral cavity, or a past history of tumor resection. Here, we report a 77-year-old woman who was scheduled to undergo scar revision. At the age of 65 years, she had been diagnosed as having depression. She had also undergone five previous oral and maxillofacial surgeries. Preoperative testing was normal. Her middle face was denting and her mouth-opening capacity was about 15 mm. We opened a field to correspond to in oral cavity by incision preoperatively this time because difficulty of the airway maintenance was expected in the patients that opening and shutting became impossible with lips by a scar after the tumors of oral cavity resection and experienced a successful case for subconscious endotracheal intubation with the sevoflurane by also using McGRATH^®MAC. Dentistry anesthesiologists sometimes encounter difficult intubation cases in patients who have previously undergone oral surgery. Difficult intubation cases can occur not only because of the degree of difficulty in the actual intubation, but also because of a patient’s background and surgical history;in such cases, the selection of an appropriate induction method and anesthetic and the use of an appliance might be necessary to perform general anesthesia safely and easily.