Fluoroscopy assisted tracheal intubation in a case of anticipated difficult airway: Fail safe devices can also fail

Abstract

Difficulty in airway management is the most important cause of major anesthesia-related morbidity and mortality. Unexpected difficulties may arise even with proper preanesthesia planning. Here, we report a case of anticipated difficult airway primarily planned for flexible fibreoptic bronchoscope assisted intubation, but due to unexpected failure of light source, fluoroscopy was used, and the airway was successfully secured.

C-arm fluoroscopy for tracheal intubation in a patient with severe cervical spine pathology

“…also reported awake fiberoptic intubation under fluoroscopic guidance performed because of unexpected failure of the light source. [ 7 ] In contrast, in our case, to avoid patient suffering caused by awake intubation, we used PLMA and a gum-elastic bougie for tracheal intubation under general anesthesia and C-arm fluoroscopic guidance. PLMA allows a more effective seal compared to the classic LMA (Teleflex, Morrisville, NC, USA) and i-gel (Intersurgical, Wokingham, UK).…”

“…We have identified clinical reports on fluoroscopy-assisted tracheal intubation for difficult airways. [ 6 7 ] Reier et al . reported awake tracheal intubation under C-arm fluoroscopic guidance in a patient with severe cervical spine pathology.…”