Ankylosing spondylitis: what all should anaesthesiologist know?

Abstract

Ankylosing Spondylitis (AS) may present significant issues to the anaesthesiologist as potential difficult airway, respiratory and cardiovascular complications, and the concomitant medication therapy to modify symptoms and disease. Awake fibreoptic intubation (AFOI) is a safe option in anticipated difficult airway, as it permits neurological monitoring throughout the attempt at achieving definitive airway. Central neuraxial blockade and peripheral nerve blocks may have good application for these cases. This morbidity renders the patients to greater risk of neurological complications in the peri-surgical period. Neurophysiological monitoring assists the clinician in timely diagnosis and intervention during surgery for cervical spine deformity correction. Addition of anti-tumour necrosis factor-α agents to the medical management has resulted in improved outcomes, however, with concomitant increased potential for wound infections in treated patients. Understanding of potential issues can pave the way for appropriate perioperative management.

Difficult airway management in an ankylosing spondylitis case using video laryngoscope: a case report

“…In this patient we found neck and temporomandibular joint stiffness that cause difficulty in airway management. 1,3 Unfortunately there was no evidence that support this patient has AS, only based on patient's wife history taking and patient appearance.…”

“…In late stage, AS patients may have cervical as well as the temporomandibular joint involvement that can lead to the difficult airway. 1,3 In this report, we present an AS patient with severe ARDS due to COVID-19 who was successfully intubated using video laryngoscope.…”

“…Ankylosing spondylitis (AS) known as autoimmune disease with chronic inflammation within sacroiliac and spine bone, characterized with bamboo spine. 1,2 Its prevalence usually young adults male patients, especially between 20 to 30 years old. It has strong associated with human leukocyte antigen (HLA-B27) in most of the cases.…”