Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine

Raval, C; Patel, Heena; Patel, Pranoti; Kharod, Utpala

doi:10.4103/1658-354x.62616

Cited by 16 publications

(11 citation statements)

References 18 publications

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“…[ 31 – 33 ] Retrograde oral or nasal and submental intubation, utilizing epidural catheter may be other good alternative in difficult or failed intubations. [ 34 35 ]…”

Section: Discussionmentioning

confidence: 99%

Airway management in patients with maxillofacial trauma - A retrospective study of 177 cases

Raval

Rashiduddin²

2011

Saudi J Anaesth

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Background:Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently.Methods:One hundred and seventy-seven patients of maxillofacial injuries, operated over a period of one and half years during July 2008 to December 2009 in Al-Nahdha hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of difficult airway management.Results:The major etiology of injuries were road traffic accidents (67%) followed by sport (15%) and fall (15%). Majority of patients were young in the age group of 11-30 years (71 %). Fracture mandible (53%) was the most common injury, followed by fracture maxilla (21%), fracture zygoma (19%) and pan-facial fractures (6%). Maxillofacial injuries compromise mask ventilation and difficult airway due to facial fractures, tissue edema and deranged anatomy. Shared airway with the surgeon needs special attention due to restrictions imposed during surgery. Several methods available for securing the airway, both decision-making and performance, are important in such circumstances. Airway secured by nasal intubation with direct visualization of vocal cords was the most common (57%), followed by oral intubation (17%). Other methods like tracheostomy and blind nasal intubation was avoided by fiberoptic bronchoscopic nasal intubation in 26% of patients.Conclusion:The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the possibility of leaving the patient without wiring an open mouth and alternative techniques like fiberoptic bronchoscopic intubation, it is unnecessary to carry out tracheostomy for securing the airway as frequently as in the past.

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“…[ 31 – 33 ] Retrograde oral or nasal and submental intubation, utilizing epidural catheter may be other good alternative in difficult or failed intubations. [ 34 35 ]…”

Section: Discussionmentioning

confidence: 99%

Airway management in patients with maxillofacial trauma - A retrospective study of 177 cases

Raval

Rashiduddin²

2011

Saudi J Anaesth

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“…It has been used in conscious, sedated or apnoeic patients [3][4][5] . It has been performed in the supine, prone and sitting positions 6 and has been used successfully in both adults 7,8 and the paediatric population 9-11 as young as 4 months old. There is also a report about the successful placement of a doublelumen endotracheal tube using the retrograde intubation technique to perform an approach to a lesion in the right lung 12 .…”

Section: Introductionmentioning

confidence: 99%

Retrograde intubation: An old new technique

Vieira¹,

Lages²,

Dias³

et al. 2013

OA Anaesthetics

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Introduction In the last decade, a new boom of scientific articles about retrograde intubation has been published. Case reports, applications, technique variations and comparison with other techniques reintroduce the scientific discussion of the technique, its indications, contraindications, complications and technical advances. Despite the complications and contraindications linked to retrograde intubation, its utility is incontestable in specific situations. Although the success rate of retrograde intubation is variable, some authors affirm that in the hands of those who use the technique frequently, retrograde intubation appears to have a high success rate. We believe that training in retrograde intubation would definitely be an advance that could increase the success rate of the technique as well as decrease the complications associated with it. Conclusion Recent developments are happening to enhance the retrograde intubation technique, such as the combination with laryngeal nerve block, fibre optic bronchoscopy and ultrasound guidance. During the booming phase of advances in airway management technologies, anaesthesiologists should sometimes return to the basics and learn and practice simple techniques like retrograde intubation that can save patient lives.

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“…However, it is a blind procedure and is often associated with complications such as nasal bleeding, subcutaneous emphysema, and failure to retrieve through the nose [ 1 ]. Risk of epidural catheter coiling due to the thin pliable design and occasional ethmoidal perforation with cerebrospinal fluid leak, has also been reported [ 2 3 ]. Here, we describe a novel modification to the existing procedure that makes it simpler for the anesthetist and safer for the patient.…”

mentioning

confidence: 99%