Face-to-face intubation using a lightwand in a patient with severe thoracolumbar kyphosis: a case report

Jeong, Hyungmo; Chae, Min-Chul; Seo, Hyungseok; Yi, Jae-Woo; Kang, Jong-Man; Lee, Bong-Jae

doi:10.1186/s12871-018-0556-y

Cited by 5 publications

(7 citation statements)

References 13 publications

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“…[424][425][426][427][428] Case reports observed successful intubations with lighted and optical stylets (Category B4-B evidence). [429][430][431][432][433][434][435][436][437] Rigid bronchoscopes. The literature is insufficient to evaluate the benefit or harm of the rigid bronchoscope for patients with anticipated difficult airways.…”

Section: Practice Guidelines For Difficult Airway Managementmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

663

547

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The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.

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Section: Practice Guidelines For Difficult Airway Managementmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

663

547

View full text Add to dashboard Cite

show abstract

“…[ 9 ] Glottic visualization is easier in the sitting position due to the tendency of the tongue to fall into the inferior oral cavity, not posteriorly to the oropharynx. Comparison studies on airway mannequins[ 10 ] and cadavers[ 11 ] positioned upright have shown statistically insignificant differences in first-pass success and intubation time. In the present case, the advantages of having the patient sitting upright are more pronounced, as his shredded tongue would have been more difficult to displace with the laryngoscope blade.…”

Section: Discussionmentioning

confidence: 99%

Face-to-face awake intubation in an upright position in severe maxillofacial trauma

Ayuningtyas,

Mutiar,

Airlangga

2024

Turkish Journal of Emergency Medicine

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Maxillofacial injury may cause difficulty during airway assessment and management in the emergency setting. Alternative intubation positions and techniques should be considered to ensure patient safety. A 37-year-old male patient arrived at the emergency department with a degloving maxillofacial injury after a high-impact motor vehicle accident. Active bleeding from his wounds prevented him from lying supine and raised concerns of aspiration, requiring immediate securing of the airway. Since the patient was alert and cooperative, awake face-to-face intubation in the upright position was performed. Intubation was successful on the first attempt without any complications using a video laryngoscope with topical anesthesia sprayed intraorally. Awake intubation in the face-to-face upright position can be successful in a cooperative patient with severe maxillofacial trauma.

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“…The skill of face-to-face intubation enables airway management in a patient in an unusual position not only in bariatric procedures. [3] Another point to discuss is using a video laryngoscope with a channel (a channeled blade) which might be a facilitation of an intubation technique. It is difficult to define how important using the channeled blade was regarding the face-to-face method for results of the study.…”

Section: Discussionmentioning

confidence: 99%

“…spondyloarthritis), the intubation efforts performed by a person standing in front of a patient might be the only option for successful airway management. [1][2][3] In case of general anesthesia in morbidly obese patients with body mass index over 40 kg m −2 , the face-to-face method may be considered as the patient is placed in head-elevated laryngoscopy position with the upper body elevated. Such an approach is recommended in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

A comparison of face-to-face endotracheal intubation and standard intubation using Airtraq video laryngoscope in morbidly obese patients: A randomized controlled trial

2022

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Background: Routine endotracheal intubation requires a patient in supine position with an operator standing behind the patient’s head. In case of a morbidly obese patient positioned in the recommended semi-recumbent position, an alternative method can be considered. Face-to-face intubation can be used both in patients in sitting as well as in prone position and when there is difficult access to the head. Evaluation of effectiveness and safety of face-to-face intubation in morbidly obese adult patients with body mass index over 40 kg m−2. Methods: The study was approved by the Local Ethics Committee and written informed consent from patients was obtained. We conducted a parallel randomized controlled trial with patients scheduled for elective sleeve gastrectomy. The trial was registered in ClinicalTrials with a number NCT04959149. Randomization and allocation to trial groups were carried out using the envelope method. The primary outcomes were the time of intubation and the first pass success of endotracheal intubation. Results: 76 patients (routine intubation n = 36, face-to-face intubation n = 40) were included in the study with no dropouts. The intubation success rates were 82.5% versus 100%, mean intubation time was 17.1 ± 18 seconds versus 29 ± 11 seconds and the need for additional maneuvers (backward, upward, rightward pressure or flexing the neck) was 15% versus 19.5%, in face-to-face and routine intubation, respectively. No injuries to teeth or mucosa have been reported. There were no incidents of desaturation below 92% or other complications associated with intubation. Conclusion: Face-to-face intubation is shorter than the routine intubation in obese patients. This method may be an alternative to standard intubation in case of airway management in morbidly obese patients in semi-erect position; however, it requires both training and practice.

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Face-to-face intubation using a lightwand in a patient with severe thoracolumbar kyphosis: a case report

Cited by 5 publications

References 13 publications

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway *

Face-to-face awake intubation in an upright position in severe maxillofacial trauma

A comparison of face-to-face endotracheal intubation and standard intubation using Airtraq video laryngoscope in morbidly obese patients: A randomized controlled trial

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