Perioperative Airway Management in Deep Neck Space Infections
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 3
Abstract
Introduction: Airway management in deep neck infection are contraversial. In our study we retrospectively reviewed perioperative airway management methods practiced in the last 30 consecutive cases of deep neck infection. Materials and Methods: Inclusion criteria was deep neck space infection patients requiring surgical drainage under general anaesthesia. Exclusion criteria were small abscess managed medically and abscess drained under local anaesthesia. Patients were grouped into tracheostomy, fiberoptic intubation, blind nasal intubation and rigid laryngoscopic intubation. Results: In our study all 19 patients who had trismus were planned for fiberoptic intubation. It was successful in all 19 patients. Laryngoscopic intubation was attempted in 11 patients, 7 patients with good mouth opening and in 4 patients with severe stridor. However 2 patients in stridor who could not be intubated with laryngoscope, underwent emergency tracheostomy. In 6 patients tracheostomy was done along with incision and drainage for post-op airway management. Five patients were sent to intensive care unit with endotracheal tube, 3 out of this proceed to tracheostomy within 4 days. Rest of the patients were extubated immediately after surgery. Discussion: Fiberoptic intubation is a very safe airway management in trained hands when adequate time is available. Trial of rigid laryngoscopy can be given only with tracheostomy backup during emergency. Patients with advanced deep neck infection requiring post-operative airway are better managed with tracheostomy than with endotracheal tube. Conclusion: Fiberoptic intubation for general anaesthesia and tracheostomy for postoperative airway in advanced cases gave good results in our study.
Authors and Affiliations
C. B. Sridhar
Keywords
Related Articles
- EP ID EP471517
- DOI 10.21088/ijaa.2349.8471.4317.14
- Views 94
- Downloads 0
Comparison of Modified Mallampati Test and Upper Lip Bite Test in Prediction of Difficult Endotracheal Intubation: A Prospective Study
Introduction: Unanticipated difficult laryngoscopic tracheal intubation accounts for a significant proportion of adverse anaesthetic outcome in clinical practice. Hence, it is important to identify patients with difficul...
Comparative Study of Intrathecal Bupivacaine with 50 and 75 µg Clonidine in Lower Abdominal Surgeries
Background: Spinal anaesthesia is a safe, reliable, inexpensive technique of providing anaesthesia and blunts autonomic, somatic and endocrine responses. It has many advantages; the limited duration of action appears to...
Platelet Indices as Indicators of Severity of Sepsis
o compare Platelet indices with SOFA scores of patients with sepsis in order to assess the relationship between platelet indices like MPV and PDW and the severity of sepsis. Settings and Design: A total of 100 patients w...
Awake Fiberoptic Intubation with Two Different Techniques of Local Anaesthetic Administration (Transtracheal Injection Versus Ultrasonic Nebulization) in Patients Undergoing Maxillofacial Surgery
Background and Aims: Awake fiberoptic intubation (AFOI) is considered the gold standard for anticipated difficult intubation in maxillofacial surgery. Regional anaesthesia of the airway is essential for awake fiberoptic...
Proseal Laryngeal Mask Airway: An Alternative to Endotracheal Intubation in Adult Patients for Surgical Procedures Under General Anaesthesia
Introduction: An endotracheal tube always considered to be the gold standard to maintain an airway because of its inherent ability to provide positive pressure ventilation [1,2]. Haemodynamic responses, situations of fai...