The maintenance of vital functions depends on the preservation and maintenance of airway patency. Conditions that may cause difficult airway such as laryngeal mass require rapid and safe intervention. In this presentation, we aimed to review our knowledge on this subject by presenting a patient who required emergency airway intervention and in whom we opened a tracheostomy under sedation. A 59-year-old male patient who was scheduled for total laryngectomy and neck dissection due to laryngeal cancer in the otorhinolaryngology (ENT) service was taken to the operating room with the decision of emergency tracheostomy after developing respiratory distress during follow-up in the service. Nasoendoscopic visualization of the patient showed an exophytic lesion starting from the root of the tongue on the left and extending to the chordae. IV fentanyl and IV dexmedetomidine were administered to the patient for sedation and dexmedetomidine infusion was started after the loading dose was administered within 10 minutes. When the thyroid isthmus was encountered during the surgical intervention, a trekeostomy was opened at 45 minutes following partial ismettomy. When a 7.5-cuff cannula was inserted and respiratory control was achieved, the operation was terminated. As in every emergency tracheostomy case, our priority was to ensure a safe airway. In order not to affect breathing, we preferred dexmedetomidine in this patient, whose airway control is difficult. We wanted to report that this combination of dexmedetomidine and fentanyl can be used safely in these cases.
Key words: tracheostomy, dexmedetomidine, diffuculut airway
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