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Predicted difficult airway — FRCA Final MCQ

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ModerateGeneral AnaesthesiaPredicted difficult airwayFRCA Final

A 52-year-old woman with predicted difficult airway requires elective maxillofacial surgery. She has limited mouth opening, previous radiotherapy, Mallampati 4 view, and reduced neck movement. She is cooperative and has normal oxygen saturation at rest. What is the most appropriate anaesthetic technique?

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Correct answer: D — Awake tracheal intubation with topicalisation and sedation

Multiple predictors suggest a difficult airway after induction, and awake tracheal intubation preserves spontaneous ventilation and airway tone while securing the airway. Induction before securing the airway risks loss of airway patency and difficult rescue oxygenation. A supraglottic airway is not definitive for maxillofacial surgery with this airway profile. Good awake intubation requires preparation, topical local anaesthesia, patient communication and backup planning.

Reference: DAS awake tracheal intubation guideline 2019