Book review
https://doi.org/10.20471/acc.2023.62.s1.18
Awake Fiberoptic Tracheal Intubation and At-Risk Extubation in a Patient with Anticipated Difficult Airway Due to Post-Traumatic Ankylosis of Temporomandibular Joints
Ivan Beneš
; Department for Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb University Hospital Center, Zagreb, Croatia
Mislav Kasalo
; Department for Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb University Hospital Center, Zagreb, Croatia
Renata Curić Radivojević
orcid.org/0000-0002-3666-0516
; Department for Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb University Hospital Center, Zagreb, Croatia
Igor Blivajs
; Department of Otolaryngology, Head and Neck Surgery, Zagreb University Hospital Center, Zagreb, Croatia
Dinko Leović
; Department of Otolaryngology, Head and Neck Surgery, Zagreb University Hospital Center, Zagreb, Croatia; Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Andrea Peršin Beraković
; Department for Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb University Hospital Center, Zagreb, Croatia
Abstract
In this case report we present successful airway management in a patient with predicted
difficult airway using the Difficult Airway Society guidelines. Our patient presented with recurrence
of severely reduced mouth opening due to post-traumatic bilateral temporomandibular ankylosis,
and was scheduled for surgical resection of the mandibular articular processes. Awake fiberoptic intubation
was planned. After light sedation and thorough topicalization of the nasal cavity the flexible
optic bronchoscope was successfully navigated into the trachea with ‘spray-as-you-go’ technique and the
endotracheal tube was railroaded over it. After a two-point check of the endotracheal tube placement the
patient was put under anesthesia. The surgery was uneventful. Finally, a plan with surgeons for safe extubation
was made and the patient was extubated uneventfully on the next day using the airway exchange
catheter in the intensive care unit.
Keywords
Awake tracheal intubation; At-risk extubation; Difficult airway; Trismus
Hrčak ID:
307518
URI
Publication date:
1.4.2023.
Visits: 774 *