[Efficacy and safety of AirWay Scope in using a bronchofiberscope in patients with difficult airway].
Case 1: A 41-year-old woman was scheduled for pinning of fractured finger and repair of a ligamentum. Preoperative problems did not exist except mandibular hypoplasia. General anesthesia was induced and Cormack classification was grade III in laryngeal view by laryngoscope and we tried a new videolaryngoscope PENTAX-AirWay Scope (AWS). We did not catch the epiglottis directly by Intlock and the target mark was not located at the middle of the vocal cord. Bronchofiberscope was guided to the vocal cord through a tracheal tube attached to AWS by another anesthesiologist and the patient was successfully intubated. Case 2: A 46-year-old man was scheduled for anterior screw-plate fixation due to C3/4 herniated disc. AWS using bronchofiberscope procedure was tried to keep the neutral position of the neck. The patient was successfully intubated. We did not view the bronchofiberscope and used it just as a flexible bougie. Case 3: A 56-year-old man was scheduled for free radial forearm flap reconstruction of a diabetic necrotic toe. Ten minutes were needed to finish intubation due to difficult airway (Cormack classification grade III) when free latissimus dorsi flap reconstruction was perfomed two month before. Hence, AWS using a bronchofiberscope procedure was tried first and 39 seconds were needed to intubate. We concluded that AWS using bronchofiberscope procedure was useful for patients with difficult airway, though two anesthesiologist, one keeping AWS and the other using a bronchofiberscope, were needed.
Nakasuji
Masato
M
Department of Anesthesiology, Kansai Denryoku Hospital, Osaka 553-0003.
Tanaka
Masuji
M
Imanaka
Norie
N
Nakamura
Mitsuyo
M
Higuchi
Mariko
M
Nomura
Masataka
M
Kawashima
Hiroko
H
D000328:Adult; D000768:Anesthesia, General; D020680:Bronchoscopes; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged; D055100:Optical Fibers; D012449:Safety