Case Report

Role of Regional Blocks in Awake Intubation in Emergency Airway Managements in Mandibular Hypoplasia or Ankylosis

Abstract

Awake intubation is the choice for airway management in anticipated difficult airway (DA), which means establishing airway without induction of deep sedation; however, in cases where sedation is precarious, decision in emergency situations, success in awake intubation is dependent on proper regional airway block. A 21 year old man with bilateral temporo-mandibular ankyolosis and a 25 years old female with mandibular hypoplasia suspected of having Pierre Robin syndrome were candidate for elective facial plastic surgery. Case one was intubated by flexible fiberoptic bronchoscope and case two with retrograde intubation. In DA with mandibular problem, awake intubation is indicated under regional airway block and topicalization.

Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013; 118(2):251-70.

Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW. Management of the difficult airway: a closed claims analysis. Anesthesiology. 2005; 103(1):33-9.

Metzner J, Posner KL, Lam MS, Domino KB. Closed claims' analysis. Best Pract Res Clin Anaesthesiol. 2011; 25(2):263-76.

Heidegger T. Difficult Airway Society guidelines 2015: what about the anticipated difficult airway? Anaesthesia. 2016; 71(4):467-8.

Behringer EC. Approaches to managing the upper airway. Anesthesiol Clin North America. 2002; 20(4):813-32, vi.

Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology. 1991; 75(6):1087-110.

American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003; 98(5):1269-77.

Weiss YG, Deutschman CS. The role of fiberoptic bronchoscopy in airway management of the critically ill patient. Crit Care Clin. 2000; 16(3):445-51, vi.

Normand KC, Aucoin AP: Retrograde intubation. In Hagberg CA, Artime CA, Daily WH, editors: The difficult airway: a practical guide, Oxford, 2013, Oxford University Press, pp 109-115.

Johnston KD, Rai MR. Conscious sedation for awake fibreoptic intubation: a review of the literature. Can J Anaesth. 2013; 60(6):584-99.

Files
IssueVol 3 No 1 (2017): Winter QRcode
SectionCase Report(s)
Keywords
regional awake intubation mandible ankylosis

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hashemian M, Samadi S, Mohajerani SA. Role of Regional Blocks in Awake Intubation in Emergency Airway Managements in Mandibular Hypoplasia or Ankylosis. Arch Anesth & Crit Care. 2017;3(1):297-299.