Airway management for general anesthesia in patients with rheumatic diseases – new possibilities

Gaszyński, Tomasz

doi:10.5114/reum.2019.84810

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Patients with rheumatoid arthritis present with morphological changes in their temporomandibular joints and cervical spine. Aside from the problems with mouth opening, these patients may also present with atlanto-axial subluxation, which can cause spinal cord damage during intubation ( 17 ). The pathology of cervical spine includes discopathy, sclerosis, and instability of vertebral joints.…”

Section: Discussionmentioning

confidence: 99%

“…The pathology of cervical spine includes discopathy, sclerosis, and instability of vertebral joints. Cricoarytenoid dysfunction is another obstacle; patients may present with symptoms such as dysphagia, hoarseness, stridor, or even airway obstruction ( 17 ). Involvement of the ligaments and odontoid can cause atlanto-axial instability without clinical manifestation.…”

Section: Discussionmentioning

confidence: 99%

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Airway Management in Neuroanesthesia

Murselović

2023

ACC

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Neurosurgical patients have specific airway management. Various conditions and diagnoses make intubation difficult and may also cause neurological damage. Spinal pathology, neurotrauma, cervical spine surgery, and pituitary gland surgery are just some examples. The aim of this review article is to present a broad spectrum of neurosurgical operations and potential complications in maintaining airway patency related to these issues. Quality perioperative preparation is a prerequisite to avoid the potentially irreversible consequences of difficult airways with a poor neurological or even fatal outcome. Patients with tumors of the pituitary region who present with Cushing's disease are prone to difficult ventilation, tracheal obstruction and difficult intubation. Awake craniotomy is also a challenge for the anesthesiologist, given that access to the airway is problematic due to the fixed frame. Unstable cervical spine occurs in cases of rheumatoid arthritis or blunt trauma, requiring precautions to be taken with spinal stabilization during intubation and induction. Pharyngeal edema and hematomas, possible complications of cervical spine surgery can endanger airway patency after extubation; postoperative patient supervision is thus required. Due to the potential threat to the patient's airway during neurosurgical procedures, quality anesthetic preoperative preparation is necessary to avoid irreversible damage and death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Airway Management in Neuroanesthesia

Murselović

2023

ACC

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“…The face-to-face technique, also known as inverse intubation, "Tomahawk," or "Pickaxe" method, can be employed for patients trapped in a vehicle [49] or those with spondylarthrosis [50]. However, this method requires good experience and should only The face-to-face technique, also known as inverse intubation, "Tomahawk," or "Pickaxe" method, can be employed for patients trapped in a vehicle [49] or those with spondylarthrosis [50]. However, this method requires good experience and should only…”

Section: Elective Tracheal Intubation Using the Face-to-face Techniquementioning

confidence: 99%

Section: Elective Tracheal Intubation Using the Face-to-face Techniquementioning

confidence: 99%

New Devices, Innovative Technologies, and Non-Standard Techniques for Airway Management: A Narrative Review

Gaszyński,

Gómez-Ríos,

Serrano-Moraza

et al. 2023

Healthcare

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A wide range of airway devices and techniques have been created to enhance the safety of airway management. However, airway management remains a challenge. All techniques are susceptible to failure. Therefore, it is necessary to have and know the greatest number of alternatives to treat even the most challenging airway successfully. The aim of this narrative review is to describe some new devices, such as video laryngeal masks, articulated stylets, and non-standard techniques, for laryngeal mask insertion and endotracheal intubation that are not applied in daily practice, but that could be highly effective in overcoming a difficulty related to airway management. Artificial intelligence and 3D technology for airway management are also discussed.

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“…Intubation in a non-standard position such as face-to-face is also used in anesthesia for patients with various medical conditions that do not allow for the patient to be placed in a supine position (e.g., rheumatoid arthritis [ 7 ]). In emergency settings, a face-to-face intubation may be utilized in trauma patients entrapped in crashed vehicles [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of a Standard Macintosh Blade Laryngoscope, Pentax-AWS Videolaryngoscope and Intubrite Videolaryngoscope for Tracheal Intubation in Manikins in Sitting and Prone Positions: A Randomized Cross-Over Study

Gaszyński

2020

Diagnostics

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Background: Intubation of a patient in different positions may be done not only in emergency settings, but also in routine anesthesia (e.g., prone position for lumbar spine surgery). Methods: The aim of the study was to compare the classic Macintosh blade laryngoscope with two videolaryngoscopes: the Pentax-AWS and the Intubrite in a simulated scenario of a manikin placed in a sitting and prone position. Additionally, intubation with the use of all three devices was performed in a standard supine position as the control group. The time of intubation and the pressure exerted on the tongue was assessed. The ANOVA Friedman (analysis of variance) and Wilcoxon with Bonferroni correction tests were used for statistical analysis. Results: The time of intubation in a prone position was significantly shorter for the Pentax-AWS videolaryngoscope compared to the Macintosh and the Intubrite. There were no significant differences in the obtained results of the evaluated devices in sitting and standard positions. The lowest pressure exerted on the tongue was with the Pentax-AWS, followed by the Intubrite and the Macintosh laryngoscopes. Conclusions: The use of the Pentax-AWS was associated with faster tracheal intubation, creating lower pressure on tongue when compared with standard Macintosh and Intubrite laryngoscopes in both prone and sitting positions.

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Airway management for general anesthesia in patients with rheumatic diseases – new possibilities

Cited by 6 publications

References 8 publications

Airway Management in Neuroanesthesia

Airway Management in Neuroanesthesia

New Devices, Innovative Technologies, and Non-Standard Techniques for Airway Management: A Narrative Review

A Comparison of a Standard Macintosh Blade Laryngoscope, Pentax-AWS Videolaryngoscope and Intubrite Videolaryngoscope for Tracheal Intubation in Manikins in Sitting and Prone Positions: A Randomized Cross-Over Study

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