Awake Retromolar Bonfils Intubation in Patient with Very Low Mouth Opening
Journal Title: Enliven: Journal of Anesthesiology and Critical Care Medicine - Year 2016, Vol 3, Issue 3
Abstract
According to the Italian Society of Anesthesiology (SIAARTI) guidelines, an awake fiberoptic intubation is the gold standard to manage a predicted difficult airway. At our institution, we are experienced in the use of the Bonfils Fiberscope® (Karl Storz), a rigid fiber optic metallic stylet, to intubate patients with expected difficult airways as well as patients with unexpected difficult airways after failed direct laryngoscopic intubation. We performed an awake retromolar fiber optic intubation in a 42-yr-old man with a temporo-mandibular anchilosis, with a very low mouth opening, with a Mallampati class 4 and an interincisor distance of 1,2 cm. A conscious sedation was performed by the administration of i.v. midazolam 0.03 mg/kg and fentanyl 2 mcg/kg. The topical anesthesia consisted in the administration of lidocaine spray 10% puffs in the oral cavity, in particular in the right vestibule with the adjunct of an instillation of lidocaine 1 % on the glottis aditus through an atomizer (Optispray®) under endoscopic vision. The retromolar approach is the method of choice in patients with limited mouth opening compared to the paraglossic technique; since the device is introduced laterally in the vestibule of the oral cavity, it can be well tolerated by the patient.
Authors and Affiliations
Pecora Luca, Falcetta Stefano, Donati Mariella, Pelaia Paolo
Keywords
Related Articles
- EP ID EP625932
- DOI -
- Views 159
- Downloads 0
Postoperative Myocardial Infarction following Noncardiac Surgery; A Case Report
Postoperative myocardial infarction (PMI) is associated with mortality and morbidity in patients undergoing cardiac or noncardiac surgery. In this case report a patient with PMI and cardiac arrest with successful outcome...
Support Vector Machines and Relevance Vector Machines and Their Usage
The researchers sought to use to supervised machine learning algorithms to determine the minor set of genes that can provide exact cancer from the microarray data. The importance of getting the minimum subset significant...
Glucose-Induced Resistance to Ciprofloxacin and Erythromycin in Enterococci
Model ecosystems were established to study the effect of glucose on the resistant phenotype of water source enterococcus to erythromycin (ERY) and ciprofloxacin (CIP). The mechanism of ERY and CIP-resistant were studied...
Rapid Response System in the Recognising of the Deteriorating Patients: Respiratory Complaints are the Origins
Rapid response team (RRT) system is a structure that contains a set of clinical criteria for certain conditions to detect and intervene on any abnormal signs and symptoms that do not meet these criteria by a qualified ex...
Anesthetic Considerations in Patient with Wolff-Parkinson-White Syndrome for Laparoscopic Cholecystectomy: Role of Perioperative Dexmedetomidine
Wolff-Parkinson-White (WPW) syndrome is a cardiac disorder having abnormal electrical communication between atria and ventricles. It is an uncommon disorder may be asymptomatic or present with symptoms like palpitation....