• Ricard Valero, Silvia Serrano, Ramón Adalia, Javier Tercero, Annabel Blasi, Gerard Sánchez-Etayo, Gloria Martínez, Lluis Caral, and Guillermo Ibáñez.
• Department of Anesthesiology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain. rvalero@medicina.ub.es
• Anesth. Analg. 2004 May 1; 98 (5): 1447-50, table of contents.

UnlabelledAirway management in patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. A 19-yr-old patient was brought to the emergency room in prone position with a drill bit protruding from the posterolateral aspect of his neck. The bit had entered the spinal canal below the first cervical vertebra, and placed near the odontoid peg. He was referred for surgical removal of the drill. The use of an inhaled induction of anesthesia, avoiding muscle relaxants, and ventilation through a laryngeal mask airway inserted in the prone position seemed to offer a satisfactory approach.ImplicationsManagement of patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. Anesthesia may be induced and the airway can be managed with the patient already in the prone position for surgery.

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