Fiberoptic Intubation Through a Laryngeal Mask in a Neonate With Difficult Airway: A Case Report

Securing the airway in preterm patients remains one of the most demanding aspects of anesthesia due to their unique anatomical and physiological features. These differences require a tailored approach to minimize morbidity and mortality. We present the case of a preterm baby with no predictors of a difficult airway, scheduled for a transit reconstruction surgery. On the first endeavor, an unanticipated difficult airway was encountered, leading to a cardiac arrest, and the surgery had to be postponed.  On the second occasion, a difficult airway strategy was preemptively planned, and a multidisciplinary team was involved. The patient was successfully intubated using fiberoptic bronchoscopy through a laryngeal mask at the second attempt. This case underscores the importance of careful airway assessment, anticipation of difficulties, and the application of state-of-the-art airway management techniques in neonatal and pediatric anesthesia.