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      A new low-cost method for difficult airway management in non-missile-penetrating cervical spine injury

      case-report

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          Abstract

          Accessing and maintaining the airway in penetrating cervical spine injury is a challenge for anaesthetists globally. This is more so in resource-poor settings, where advanced techniques for intubation in difficult airway situations are unavailable. We describe a new, low-cost, easily adaptable method of managing the airway used in a middle-aged man who sustained screw driver injury to the cervical spine with C4 Brown-Séquard syndrome. The deployment of readily available and cheap materials led to successful anaesthesia management of the patient.

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          Most cited references7

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          A review of 450 stabwounds of the spinal cord.

          W Peacock, Jessie A. Key, R Shrosbree (1977)
          Patients with spinal cord stabwounds accounted for over one-quarter of the more than 1 600 patients with spinal cord injury admitted to this unit during 13 years. Over half the lesions were of the Brown-Séquard type. Functional recovery was good in nearly two-thirds of patients. The principles of treatment are discussed.
          Article 0 comments Cited 31 times – based on 0 reviews     Review now
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            Induction of anesthesia and insertion of a laryngeal mask airway in the prone position for minor surgery.

            Graham Smith, David G Raitt, Alexander Ng (2002)
            The use of the prone position for surgery presents potential obstacles to rapid tracking of patients during ambulatory anesthesia. We describe a prospective audit of 73 patients who placed themselves in the prone position; anesthesia was induced in this position and a laryngeal mask airway (LMA) was used to maintain the airway. Additional increments of propofol were given to one patient who had laryngospasm and to nine who required deepening of anesthesia before the LMA could be inserted. Of four cases with LMA malpositioning, the LMA was adjusted easily in three, but in one patient who was edentulous, it was necessary to hold the LMA for the duration of the procedure. Manual ventilation of the lungs via the LMA was required because of arterial oxygen desaturation and hypoventilation in four patients. Blood was noted outside the nostrils in two patients, presumably caused by soft tissue trauma after insertion of the LMA, and bradycardia occurred in five patients. In the postoperative period, hoarseness and sore throat were observed in one and six patients, respectively. With experience and appropriate patient selection, it is possible to induce and maintain anesthesia using a LMA in patients in the prone position for ambulatory surgery. With experience and appropriate patient selection, it is possible to induce and maintain anesthesia using a laryngeal mask airway in patients in the prone position for ambulatory surgery.
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              Stab wounds of the spinal cord.

              R LIPSCHITZ, Torin Block (1962)
              Article 0 comments Cited 13 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Anaesth
                Journal ID (iso-abbrev): Indian J Anaesth
                Journal ID (publisher-id): IJA
                Title: Indian Journal of Anaesthesia
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0019-5049
                ISSN (Electronic): 0976-2817
                Publication date (Print): Mar-Apr 2012
                Volume: 56
                Issue: 2
                Pages: 162-164
                Affiliations
                [1 ]Department of Surgery, Division of Neurological Surgery, Federal Medical Centre, Ido-Ekiti, Nigeria
                [2 ]Onward Specialist Hospital, Osogbo, Nigeria
                [3 ]Department of Anaesthesia, LAUTECH Teaching Hospital, Ogbomoso, Nigeria
                Author notes
                Address for correspondence: Dr. Taopheeq B Rabiu, Department of Surgery, Division of Neurological Surgery, Federal Medical Centre, Ido-Ekiti, Nigeria. E-mail: eshohealth@ 123456gmail.com
                Article
                Publisher ID: IJA-56-162
                DOI: 10.4103/0019-5049.96329
                PMC ID: 3371492
                PubMed ID: 22701208
                SO-VID: c3fa48d0-f02b-4d43-a7ff-a8acfbf1dc5b
                Copyright © Copyright: © Indian Journal of Anaesthesia
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: low-cost method,difficult airway,penetrating cervical spine injury,developing countries
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: low-cost method, difficult airway, penetrating cervical spine injury, developing countries

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