An Anesthetic Approach for a Patient with Known Difficult Airway Undergoing an Ommaya Reservoir Placement

We describe the anesthetic management of a patient with a known difficult airway secondary to a tumor in the oropharynx in need of an Ommaya Reservoir. The surgical team preferred to perform the procedure under monitored anesthesia care to avoid manipulation of the patient's airway due to the possibility of dislodging friable tissue. We report the successful use of local anesthesia and dexmedetomidine infusion, as the primary sedative agent for intraoperative management of this patient.