title: [Management of difficult airway with inhalation induction in a patient with Lennox-Gastaut syndrome and neck injury].
abstract: Lennox-Gastaut syndrome is a childhood epileptic encephalopathy, and is characterized by frequent and difficult to treat seizures associated with mental retardation. The case is presented of a 21 year-old male with Lennox-Gastaut syndrome, with bilateral cervical facet joint dislocation fracture at C6-C7 and spinal canal compression as a result of a fall during a seizure. In this case the management of the difficult airway expected in an awake and uncooperative patient, with cervical spinal cord injury is described. An airway management strategy was proposed, that allowed a rapid and safe airway control with the best possible tolerance and maintaining the neck immobilised, so as not to increase neurological injury. Within this strategy, plan A was defined as inhalation induction with sevoflurane to maintain spontaneous breathing and tracheal intubation with Airtraq®. We believe that the Airtraq® video laryngoscope with inhalational induction with sevoflurane is a valid and effective alternative in the management of expected difficult airway.
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, España. Electronic address: julioreyp@googlemail.com.
authors: J
authors: J
authors: Rey
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, España.
authors: C M
authors: CM
authors: Encabo
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, España.
authors: N E
authors: NE
authors: Pizarro
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, España.
authors: J L
authors: JL
authors: San Martín
authors: Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, España.
authors: F
authors: F
authors: López-Timoneda
mesh_terms: D000058:Accidental Falls; D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001915:Braces; D002574:Cervical Vertebrae / Q000601:surgery; D004630:Emergencies; D006801:Humans; D007442:Intubation, Intratracheal; D004204:Joint Dislocations / Q000209:etiology* / Q000601:surgery; D020704:Laryngoscopes; D065768:Lennox Gastaut Syndrome / Q000150:complications*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D019838:Neck Injuries / Q000209:etiology* / Q000601:surgery; D000077149:Sevoflurane; D013117:Spinal Cord Compression / Q000209:etiology; D013168:Spondylolisthesis / Q000209:etiology / Q000601:surgery; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000293:injuries* / Q000601:surgery
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane
keywords: Airtraq(®); Difficult airway; Inducción inhalatoria; Inhalation induction; Inmovilización cervical; Lennox-Gastaut syndrome; Neck immobilization; Síndrome de Lennox-Gastaut; Video laryngoscope; Videolaringoscopio; Vía aérea difícil