The use of an i-gel supraglottic airway for the airway management of a patient with subglottic stenosis: a case report.
The airway management of patients with subglottic stenosis poses many challenges for the anesthesiologist. Although many anesthesiologists would prefer the use of a narrow endotracheal tube in this patient population, the use of laryngeal mask airways has also been described. We report the case of a patient who was managed using an i-gel supraglottic airway due to a difficulty with inserting an endotracheal tube during a previous procedure. A 47-year old woman with an ASA (American Society of Anesthesiologists) score of I was scheduled to undergo a laparoscopic cholecystectomy. An i-gel supraglottic airway was inserted without difficulty, provided a good seal, and allowed for controlled ventilation with acceptable peak pressures throughout the operation, including during pneumoperitoneum. Furthermore, the vocal cords were successfully visualized using a fiberscope, allowing the possibility of eventual fiberoptic intubation, if it had been necessary. The presence of subglottic stenosis was also confirmed using the fiberscope. Thus, the i-gel airway device has multiple features that makes it suitable for use in situations where a narrow endotracheal tube is inadvisable or too difficult to use.
Donaldson
W
W
Department of Anesthetics, Antrim Area Hospital, Antrim, UK.
Michalek
P
P
D000769:Anesthesia, Inhalation; D017081:Cholecystectomy, Laparoscopic; D003251:Constriction, Pathologic; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D007818:Laryngeal Diseases / Q000473:pathology* / Q000628:therapy*; D017214:Laryngeal Masks; D008875:Middle Aged; D012121:Respiration, Artificial / Q000295:instrumentation*