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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Jurnal Anestesi Perioperatif Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico JOURNAL LA MEDIHEALTICO Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Social Research COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Journal of Anesthesiology and Clinical Research Majalah Anestesia & Critical Care (MACC) Cerdika: Jurnal Ilmiah Indonesia International Journal of Psychology and Health Science Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Made Gede Widnyana
Department Of Anesthesiology And Intensive Therapy, Faculty Of Medicine, Udayana University - Central General Hospital Prof. I.G.N.G. Ngoerah, Denpasar, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Journal : Syntax Literate: Jurnal Ilmiah Indonesia

 1 
Anesthetic Approach In A Patient With A Left Submandibular Colli Abscess and Multiple Comorbidities Richard, Richard; Mas Shintya Dewi, Dewa Ayu; Gede Widnyana, I Made
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i7.60694

Abstract

Submandibular–colli abscess accompanied by comorbidities such as diabetic ketoacidosis (DKA), airway obstruction, and chronic heart failure (CHF) presents a complex anesthetic challenge. Patients with maxillofacial abscesses and comorbidities such as impending airway obstruction, diabetic ketoacidosis (DKA), and chronic heart failure pose significant challenges to anesthetic management. Each comorbidity significantly influences perioperative management and increases the risk of morbidity and mortality. The goal of preoperative management is to stabilize the patient prior to surgery and reduce the risk of perioperative complications. Preoperative management includes ensuring adequate oxygenation, optimizing and monitoring hydration status, and controlling blood glucose levels. Objectives: To describe the perioperative anesthetic approach in a patient with a left submandibular abscess and multiple comorbidities, emphasizing the importance of a holistic strategy in managing complex surgical cases. Case Report: A 51-year-old female presented with progressive swelling of the left face and neck for two weeks. Examination revealed a submandibular abscess, DKA, and a known history of CHF. The patient reported trismus and odynophagia with marked hyperglycemia. Imaging showed tracheal deviation and abscess extension to the retropharyngeal space. Preoperative management focused on metabolic stabilization and cardiovascular optimization. Awake fiberoptic intubation (AFOI) with dexmedetomidine sedation was performed due to the anticipated difficult airway. Surgery proceeded uneventfully for 2 hours and 10 minutes, followed by intensive postoperative monitoring. Discussion: Anesthetic management in patients with deep neck abscesses and comorbid DKA and CHF requires comprehensive perioperative planning. Metabolic and hemodynamic stability must be achieved prior to induction. Careful airway planning, the use of cardiovascularly stable anesthetic agents, and vigilant glucose and fluid monitoring are essential to prevent complications. Conclusion: Successful anesthetic care in patients with submandibular abscess and complex comorbidities demands coordinated, individualized perioperative strategies to minimize risk and optimize outcomes.
Co-Authors Adinda Putra Pradhana Agrasidi, Putu Anindya Anak Agung Gde Agung Adistaya Ari Andayani Ariyasa, I Putu Eka Aryasa EM, Tjahya Astuti, Mira Kusuma Bora, Fivilia Anjelina Christopher Ryalino Cynthia Dewi Sinardja Damayanti, Elok Dewi, I Dewa Ayu Mas Shintya Eka Nantha Kusuma, Putu Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Estrada, Ronald Ganakin, Acuyta Gde Agung Senapathi, Tjokorda Gede Semarawima, Gede Hartawan , I.G.A.G. Utara Hartawan, IGAG Utara Hengki Irawan Hengki Irawan Hengky Hengky, Hengky I Dewa Gede Tresna Rismantara, I Dewa Gede Tresna I Gde Raka Widiana I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ngurah Mahaalit I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Darma Junaedi, I Made I Made Subagiartha I Nyoman Hariyasa Sanjaya I Putu Agus Surya Panji I Wayan Aryabiantara, I Wayan I Wayan Suranadi IB Krisna, IB Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jeanne, Bianca Jim Anthonio, Jim Jimmy Wongkar Johanes, Kevin Paul Jonathan, Jeremy Junaedi, I Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kenzi, Ignatio Armando Ketut Semara Jaya, Ketut Semara Kurnia, Prajnaariayi Prawira Kurniyanta, I Putu Made Adi Kusuma Made Agus Kresna Sucandra, Made Agus Kresna Made Wiryana Madyline Victorya Katipana Marilaeta Cindryani Marilaeta Cindryani Lolobali, Marilaeta Cindryani Marilaeta Cindryani, Marilaeta Mark Christsatya Bolla Mas Shintya Dewi, Dewa Ayu Nada, I Ketut Wibawa Otniel Adrians Labobar Pande Nyoman Kurniasari, Pande Pemayun, Cok Istri Dewiyani Pontisomaya Parami Putra, Agung Manik Septiana Putrawan, I Wayan Eka Putu Agus Surya Panji Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Renaldi Reynaldi Reiky Hadiwijaya Richard Richard Riko Riko Satria Pinanditas S Sidemen, I Gusti Ayu Eka Para Santi Sidemen, I.G.P.Sukrana Sidemen, IGP Sukrana Sonni Soetjipto, Sonni Sri Astuti Srinami Dewi Suastika, I Gede Juli Sutyawan, I Wayan Eka Tanggono, Aninda Tirta, Ian Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Agung Senapathi Tjokorda Gde Agung Senapathi Wanda, Aprilia Wardani, Dinar Kusuma Win Muliadi