Fiberoptic-guided retromolar intubation in an infant with in
The following case has been published in the Journal of Anaesthesiology Clinical Pharmacology.

A 6-month-old American Society of Anaesthesiologists grade I, weighing 8 kg presented with a gradually increasing intraoral swelling over 2 months. On examination, the swelling was 4–5 cm, soft in consistency, bleeding on touch, and obscuring the oral cavity. CT revealed 4–5 cm hyperdense mass arising from the anterior mandible. Diagnosis of melanotic neuroectodermal tumor of infancy was made and tumor excision was planned.

An intravenous access was secured preoperatively using eutectic mixture of local anesthetic (EMLA) application. The child was premedicated with injection glycopyrrolate 0.2 mg intravenously.

Standard monitors were applied. Inhalational induction of anesthesia was facilitated with sevoflurane in oxygen. Adequate ventilation with bag and mask was ensured. An uncuffed 3-mm ETT was passed nasally for perioxygenation. A presoftened 4.5-mm ETT was railroaded over the bronchoscope and inserted through retromolar space, retracting the cheek.

Vocal cords were easily visualized without much manipulation and the fiberscope was passed through it. The ETT was railroaded using rotational motion. The child was kept spontaneously breathing till the time airway was secured.

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