Awake fiberoptic intubation in a pediatric patient with cervical spine injuries on a halo-vest: a case report

Keywords: Airway Management, Airway Obstruction / complications, Anesthesia / methods, Child, Dexmedetomidine, Intravenous infusion, Fiber Optic Technology, Intubation, Intratracheal / methods, Laryngoscopes, Pediatric

Abstract

Awake fiberoptic intubation (AFOI) in pediatric patients remains a continuous challenge for the anesthetists, and is considered more cumbersome a procedure as compared to the adult population. The coexistence of unstable cervical spine injuries, although rare, but complicates the procedure even more. Proper pre-planning, adequate sedation and analgesia and the patient’s conscious cooperation are needed to ensure success. We describe a step-by-step approach to a successful AFOI in a 12-year-old child who had atlantooccipital instability and had a halo-vest on. Titrated dose of sedation and analgesia, obtunding airway reflex and patient’s cooperation is a key to successful AFOI in this patient.

Abbreviations: AFIO: Awake fiberoptic intubation; OMF: Oromaxillofacial; BMI: body mass index; TCI: Target-controlled infusion

Key words: Airway Management; Airway Obstruction / complications; Anesthesia / methods; Child; Dexmedetomidine, Intravenous infusion; Fiber Optic Technology; Intubation, Intratracheal / methods; Laryngoscopes; Pediatric

Citation: Hassan MH. Awake fiberoptic intubation in a pediatric patient with cervical spine injuries on a halo-vest: a case report. Anaesth. pain intensive care 2022;26(4):569-573; DOI: 10.35975/apic.v26i4.1968

Received: April 30, 2022; Reviewed: May 01, 2022; Accepted: June 28, 2022

Author Biography

Mohamad Hasyizan Hassan

Department of Anesthesiology and Intensive Care, School of Medical Science, Health Campus,

Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, 16150 Kubang Kerian, Kelantan, Malaysia.

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