Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
There is controversy regarding the optimal mode of elective tracheal intubation in the patient with an unstable cervical spine following trauma. A ten-year review of 150 patients with traumatic cervical spine injuries with well-preserved neurological function, presenting for operative stabilization, was conducted to compare neurological outcome with the mode of tracheal intubation. Preoperative neurological deficits were identified in 49 patients (33%); most were single-level radiculopathies. ⋯ There were no differences in neurological outcome whether intubation was performed while the patient was awake or under general anaesthesia, or comparing oral tracheal intubation with all other techniques (P = 0.5, Fisher exact test). Also, in-line traction did not affect neurological outcome. Oral tracheal intubation with in-line stabilization, either performed after induction of general anaesthesia or with the patient awake, remains an excellent option for elective airway management in patients with cervical spine injuries.
-
Case Reports
Minitracheostomy in elective surgery of the larynx: an alternative to formal tracheostomy.
A patient scheduled for surgical removal of a giant polyp of the larynx, and in whom difficult orotracheal intubation was anticipated in the preoperative visit, was managed successfully with a minitracheostomy performed with a Mini-Trach II kit. The ventilation achieved was adequate throughout the procedure. Thus, conventional tracheostomy was avoided.