Known difficult airway in a patient with pheochromocytoma: a case report

•Pheochromocytoma and known difficult airway represent a challenge for the anesthesiologist.•Dexmedetomidine can be used for sedation without affecting the ventilatory function.•Dexmedetomidine is useful for sedation during awake endotracheal intubation in a patient with pheochromocytoma.

The manipulation of an airway is always a critical moment in the anesthetic management of patients with pheochromocytoma due to the high incidence of undesirable hemodynamic events in relation with the stimulus represented by the laryngoscopy.A known difficult airway in which it is necessary to carry out an orotracheal intubation while preserving spontaneous ventilation subjects the patient to a stressful situation. The objective is to obtain an acceptable level of comfort and sedation avoiding respiratory depression (Anesthesiol Clin 2015;33:233-40).In this case, we describe the management of a known difficult airway in a patient with a pheochromocytoma and a personal history of arterial hypertension and chronic obstructive pulmonary disease who underwent orotracheal intubation with spontaneous ventilation with Airtraq and with dexmedetomidine as the only sedative agent.ConclusionDexmedetomidine is a useful drug for sedation during orotracheal intubation with spontaneous ventilation in a patient with pheochromocytoma and a chronic respiratory pathology (Chin Med J (Engl) 2015;128:3143-3148, J Clin Anesth 2007; 19:370-373).