SUBGLOTTIC STENOSIS AND GENERAL ANESTHESIA: CHALLENGES FOR THE ANESTHESIOLOGIST – CASE REPORT

Abstract

This article aimed to report the invasive anesthetic approach to the airway in a patient with grade I subglottic stenosis, undergoing awake orotracheal intubation under sedation with dexmedetomidine, highlighting the challenges faced by the anesthesiologist, the strategies adopted for safe airway management, and the importance of individualized anesthetic planning in patients at risk of difficult airway undergoing general anesthesia. This is a descriptive and observational case report, developed from anesthetic care provided in a hospital setting, with data collected through analysis of the electronic medical record and monitoring of the anesthetic procedure. The approach included conscious sedation with dexmedetomidine, topical airway anesthesia, and the use of videolaryngoscopy to perform awake orotracheal intubation. The results demonstrated successful intubation, without complications, airway trauma, or hemodynamic instability, with maintenance of spontaneous ventilation. The surgical procedure was uneventful, with reversal of neuromuscular blockade and safe extubation in the operating room. It is concluded that awake orotracheal intubation, combined with sedation using dexmedetomidine, topical airway anesthesia, and the use of videolaryngoscopy, constitutes a safe and effective strategy for airway management in patients with mild subglottic stenosis.