Guiding Flexible-Tipped Bougie Under Videolaryngoscopy: An Alternative to Fiberoptic Nasotracheal Intubation in Maxillofacial Surgeries

被引:7
作者
Kumar, Prashant [1 ]
Sharma, Jyoti [1 ]
Johar, Sanjay [1 ]
Singh, Virendra [2 ]
机构
[1] Univ Hth Sci, Pt BD Sharma Post Grad Inst Med Sci, Dept Anaesthesiol & Crit Care, 8FM 17 Med Enclave, Rohtak 124001, Haryana, India
[2] Univ Hth Sci, Post Grad Inst Dent Sci, Maxillofacial Surg, Rohtak, Haryana, India
关键词
Nasotracheal intubation; Flexible tipped bougie; Videolaryngoscope;
D O I
10.1007/s12663-020-01327-w
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Background Maxillofacial surgeries are known to have difficulty in airway management due to anatomical and functional reasons. Tumors of maxillofacial region and diseases of TM joint limit mouth opening as well as airway space. Various methods have been tried with success for nasotracheal intubation including fiberoptic-aided as well as blind nasal and light-guided intubation. Video laryngoscopy-assisted intubation uses visualization of glottis without the need of alignment of all the three axes of airway. Purpose Video laryngoscopy is being considered to increase the success rate in various different setups including critical care, pre-hospital and operating rooms. Flexible-tipped bougie guided by a video laryngoscope was used in patients with limited airway space undergoing maxillofacial surgery. Methods In present study, airway of five patients posted for various maxillofacial surgeries was secured by passing flexible-tipped bougie through the nasopharyngeal airway and, once under the view of a McGrath videolaryngoscope, was advanced toward the glottis; the rotation of the bougie with the required flexion of the tip helped a quick redirection of bougie to enter the larynx at an angle. Results Our experience of five cases with anticipated difficult intubation normally judged to be manageable with fiberoptic bronchoscopic intubation were managed without awake fiberoptic bronchoscopy using flexible-tipped bougie under vision of videolaryngoscopy. All patients were successfully managed with this technique. Conclusion Flexible-tipped bougie could take the direction toward glottis under a videolaryngoscope in an anticipated difficult airway, making a place for airway management in patients with limited mouth opening.
引用
收藏
页码:324 / 326
页数:3
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