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Clinical Decision-Making and Process Complications During Anticipated Difficult Airway Management for Elective Surgery.
Anesth Analg
February 2025
From the Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Background: Difficult airway management (DAM) is a challenging aspect of anesthetic care. Although nearly all DAM episodes result in successful intubation, complications are common and clinical decision-making may be complex. In adults with anticipated DAM scheduled for nonemergent surgery, we prospectively observed clinical decisions made during DAM such as awake/sedated versus anesthetized, choice of initial and subsequent devices, case cancellation/postponement, conversions between awake and anesthetized approaches, and process complications such as multiple intubation/supraglottic airway (SGA) insertion attempts, difficult bag-mask ventilation (BMV), hypoxemia, and cardiovascular destabilization.
View Article and Find Full Text PDFA Case Report of a Rescue of Unanticipated Obstetric Difficult Airway Secondary to Limited Mouth Opening With i-gel® and Establishing Definitive Airway With Aintree and Fiberscope-Guided Intubation.
AANA J
December 2024
Professor, Department of Anesthesiology, University of Texas Health Science Center at Houston, Houston, Texas.
Obstetric difficult airway management has emerged as a critical safety issue, and unsuccessful intubation can lead to morbidity and mortality. A literature review of difficult and failed obstetric intubations from the 1970s to 2015 shows that the incidence of failed intubation is unchanged, remaining at one per 390 anesthetics. Our obstetric case report highlights an obstetric difficult airway secondary to limited mouth opening; rescue of the airway with an i-gel®; and establishment of a definitive airway with the aid of an Aintree intubation catheter and flexible fiberoptic scope-guided intubation through the i-gel®, a second-generation supraglottic airway.
View Article and Find Full Text PDFAwake Supraglottic Airway Placement in Pediatric Patients for Airway Obstruction or Difficult Intubation: Insights From an International Airway Registry (PeDI).
Anesth Analg
February 2025
From the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Background: Small case series have described awake supraglottic airway placement in infants with significant airway obstruction and difficult intubations. We conducted this study to determine outcomes when supraglottic airways were placed in awake children enrolled in the international Pediatric Difficult Intubation Registry including success of ventilation, success of tracheal intubation, and complications.
Methods: We reviewed the Pediatric Difficult Intubation Registry to identify all cases of awake supraglottic airway placement before planned tracheal intubation from August 2012 to September 2023 with subsequent review of details of awake supraglottic airway placement in the medical record.
Intubating Laryngeal Mask Airway for Airway Management and Blind Tracheal Intubation Through It From 360° Around a Supine Patient: A Randomized Controlled Clinical Study in a Simulated Prehospital Emergency Scenario.
Cureus
August 2024
Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Jaipur, IND.
Article Synopsis
- In emergency situations, airway management is crucial, with endotracheal intubation being the standard method for unconscious patients, allowing for effective ventilation and removal of secretions.
- Supraglottic airways, such as the intubating laryngeal mask airway (ILMA), offer advantages like quicker insertion and less reliance on paralysis, making them useful as a backup or in difficult scenarios.
- This study aims to test the ILMA's effectiveness in prehospital settings, particularly when access around the patient's head is limited, and evaluates a new handle design for easier insertion from any angle.
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