Anaesthetic Management of a Large Orbital Tumour with Intracranial Extension: A Case Report

Large tumours involving the face cause disfigurement that creates a scenario of difficult mask ventilation and intubation. Awake fibreoptic intubation may not be feasible in all patients with difficult mask ventilation due to various reasons. In addition, surgical manipulation of tumours involving the face can elicit trigeminocardiac reflex and result in haemodynamic instability. We report a case of a large orbital lesion extending upto upper lip with intracranial extension in an uncooperative
patient managed with induction of anaesthesia with paediatric face mask. Intubation was achieved with videolaryngoscopy. Repeated surgical stimulation of mandibular and maxillary nerve resulted in trigemino cardiac reflex requiring vagolytic therapy.