Tehran University of Medical Sciences
Archives of Anesthesiology and Critical Care
2423-5849
4
1
2018
01
09
"Cannot Ventilate Cannot Intubate" scenario in a Five Years Old Girl
442
443
EN
Nader
Nazemian Yazdi
Department of Anesthesiology and pain Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arash
Jafarieh
Department of Anesthesiology and pain Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abolghasem
Yusefi
Department of Anesthesiology and pain Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
2017
07
22
2017
08
16
Difficult airway is defined as situation that face mask ventilation, laryngoscopy, or intubation cannot be done by clinician as easy as he expects where it. Difficulties in children airway management do not occur frequently and aggressive airway management in children is not required often.
We present a case of “cannot ventilate, cannot intubate” scenario in a five years old girl with a supraglottic cyst in operating room. We started to sedate the patient with ketamine for awake intubation but the cyst obstructed the airway and we couldn’t ventilate her with mask. Two try of intubation with tube and bougie were failed and rigid bronchoscope could maintain the airway finally.
https://aacc.tums.ac.ir/index.php/aacc/article/view/136
https://aacc.tums.ac.ir/index.php/aacc/article/download/136/313
bidity. This study was designed to determine the effect of ketamine spraying on the endotracheal tube cuff on sore throat, cough, and hoarseness during the first 24 hours of the postoperative period.
Methods: 120 healthy women with term singleton pregnancy scheduled for elective term cesarean delivery under general anesthesia were enrolled. Patients were randomized into two equal groups. 1 ml (50 mg) ketamine was sprayed on the endotracheal tube cuff in group K as a study group and 1 ml normal saline was sprayed on the endotracheal tube cuff in group N as a control group. The patients were interviewed for sore throat, cough, and hoarseness at 1, 6 and 24 hours after general anesthesia.
Results: In group K, no patient reported sore throat, cough and hoarseness in the first hours after surgery. However at the same time in group N the incidence of these symptoms was significantly higher than group K. The incidence of combined moderate and severe sore throat, cough and hoarseness was significantly lower in group K compared with group N, not only in 6 hours after surgery (1.67%, 0, 0 in group K vs 13.34%, 18.34%, 16.68% in group N, p<0.05) but also 24 hours after operation (1.67%, 0, 0 in group K vs13.3%, 16.6%, 11.67% in group N, p<0.05).
Conclusion: Ketamine spraying on the endotracheal tube cuff reduces the incidence of sore throat, hoarseness and cough in patients undergoing operation under general anesthesia.
https://aacc.tums.ac.ir/index.php/aacc/article/view/7
https://aacc.tums.ac.ir/index.php/aacc/article/download/7/178