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  4. AIRWAY MANAGEMENT WITH RIGID BRONCHOSCOPE IN ADULT PATIENT DURING CERVICAL SPINE SURGERY: A CASE REPORT

AIRWAY MANAGEMENT WITH RIGID BRONCHOSCOPE IN ADULT PATIENT DURING CERVICAL SPINE SURGERY: A CASE REPORT

Acta Clin Croat, 2023 · DOI: 10.20471/acc.2023.62.s1.19 · Published: January 1, 2023

Spinal Cord InjuryCritical CareAnesthesiology

Simple Explanation

The case report discusses airway management in a patient with SCIWOCTET undergoing cervical spine surgery. SCIWOCTET is a cervical spine injury with myelopathy but without fracture or ligament injury seen on initial imaging. The primary concern during anesthesia is minimizing head and neck movement to prevent further spinal cord injury. The report highlights the use of a rigid bronchoscope with manual in-line immobilization (MILI) for intubation. The authors suggest that rigid bronchoscopy with MILI is a suitable method for airway management in patients with cervical spine injuries.

Study Duration
Not specified
Participants
One 43-year-old male patient
Evidence Level
Level 4; Case Report

Key Findings

  • 1
    Rigid bronchoscopy with MILI allowed for successful intubation with minimal head and neck movement in a patient with SCIWOCTET.
  • 2
    The patient experienced postoperative neurological improvement after cervical spine surgery.
  • 3
    The use of preoxygenation and rapid sequence induction (RSI) helped avoid mask ventilation, further minimizing cervical spine movement.

Research Summary

The case report presents a patient with SCIWOCTET who underwent cervical spine surgery. Airway management was achieved using a rigid bronchoscope with manual in-line immobilization to minimize cervical spine movement. The patient showed postoperative neurological improvement, suggesting the effectiveness of the chosen airway management technique.

Practical Implications

Clinical Practice

Rigid bronchoscopy with MILI can be considered a viable option for airway management in patients with cervical spine injuries or instability.

Education and Training

Healthcare professionals involved in airway management should be trained in the use of rigid bronchoscopes and manual in-line immobilization techniques.

Equipment Availability

Hospitals and emergency departments should ensure the availability of rigid bronchoscopes and other necessary equipment for managing airways in patients with potential cervical spine injuries.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of comparison with other airway management techniques.
  • 3
    Specific to SCIWOCTET; may not apply to all cervical spine injuries.

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