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Management of Difficult Airway Due To Chop Wound In Posterior Neck

Rajdip Hazra

,

Sisir Chakraborty

,

Rajarshi Bose

,

Manjunatha SM

,

Kaushik Ghosh

,

Md. Babrak Manuar

,

Md. Nurejjaman

,

Saswati Pal

Rajdip Hazra 1 Sisir Chakraborty 2
Rajarshi Bose 3
Manjunatha SM 1 Kaushik Ghosh 5
Md. Babrak Manuar 1 Md. Nurejjaman 7
Saswati Pal 1 

  1. Department of Anesthesiology, Nilratan Sircar Medical College and Hospital, Kolkata, India 1

  2. Department of Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, India 2

  3. Department of Pediatrics, Nilratan Sircar Medical College and Hospital, Kolkata, India 3

  4. Department of Medicine, Malda Medical College and Hospital, Malda, India 5

  5. Department of Anesthesiology, Malda Medical College and Hospital, Malda, India 7


Abstract:

A 35 years old male patient presented with a chop wound in posterior neck between C2 and C3 interspace. After initial resuscitation this patient was put for surgery and general anesthesia was induced in left lateral position. Our experience suggested that a proper size ILMA (intubating laryngeal mask airway) is useful in managing difficult airway in left lateral position. Blind intubation attempt via ILMA is generally successful. We recommend routine use of ILMA as a backup plan in managing anticipated difficult intubation in nonconventional position.


Contribution/ Originality
A systemic approach with appropriate alternatives is the key behind successful management of anticipated difficult airway. Often this scenario is further complicated by emergence nature of surgery and nonconventional positioning. This paper documents successful use of ILMA in these cases as a suitable alternative. 

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Reference:

  1. S. Yamaguchi, K. Eguchi, M. Takeda, T. Hidaka, P. Shrestha, and K. Kurisu, "Penetrating injury of upper cervical spine by a chopstick- case report," Neurol Med Chir (Tokyo), vol. 47, pp. 328-30, 2007.
  2. H. Bhatoe, "Stabbed in the back?," Indian J Neurotrauma, vol. 4, pp. 9-10, 2007.
  3. M. Mahmoodie, B. Sanei, M. Moazeni-Bistgani, and M. Namgar, "Penetrating neck trauma: Review of 192 cases," Arch Trauma Res., vol. 1, pp. 14-8, 2012.
  4. N. Rao, I. Trauma, and Wound, In: Textbook of forensic medicine and toxicology, 2nd ed.: Jaypee Brothers Medical Publishers (P) Ltd, 2010.
  5. J. Mayglothling, T. Duane, M. Gibbs, M. McCunn, E. Legome, A. Eastman, J. Whelan, and K. Shah, "Emergency tracheal intubation immediately following traumatic injury: An Eastern association for the surgery of trauma practice management guideline," J Trauma Acute Care Surg., vol. 73, pp. 333-40, 2012.
  6. S. Weingart and R. Levitan, "Preoxygenation and prevention of desaturation during emergency airway management," Ann Emerg Med., vol. 59, pp. 165-75, 2012.
  7. M. Panwar, A. Bharadwaj, C. Gaurav, and D. Kalita, "Intubating laryngeal mask airway as an independent ventilatory and intubation device. A comparison between supine, right lateral and left lateral," Korean J Anesthesiol, vol. 65, pp. 306–11, 2013.
  8. T. Melissopoulou, K. Stroumpoulis, M. Sampanis, N. Vrachnis, G. Papadopoulos, A. Chalkias, and T. Xanthos, "Comparison of blind intubation through the I-gel and ILMA Fastrach by nurses during cardiopulmonary resuscitation: A manikin study," Heart Lung., vol. 43, pp. 112-6, 2014.
  9. T. Rabiu and A. Fadare, "A new low-cost method for difficult airway management in non-missile-penetrating cervical spine injury," Indian J Anaesth, vol. 56, pp. 162-4, 2012.
  10. N. Dooney and A. Daga, "Anesthetic considerations in acute spinal cord trauma," Int J Crit Illn Inj Sci., vol. 1, pp. 36-43, 2011.

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