KingVision® and dexmedetomidine for opioid-free awake intubation in a patient with Klippel-Feil syndrome for complex percutaneous nephrolithotomy in a prone position: a case report

Pagano, Tommaso; Scarpato, Fulvio; Chicone, Gianmaria; Carbone, Domenico; Muoio, Raffaele; Bussemi, Carlo; Albano, Francesco; Ruotolo, Fabio

doi:10.5114/ait.2019.89170

ait

2019

DOI: 10.5114/ait.2019.89170

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KingVision® and dexmedetomidine for opioid-free awake intubation in a patient with Klippel-Feil syndrome for complex percutaneous nephrolithotomy in a prone position: a case report

Tommaso Pagano

Fulvio Scarpato

Gianmaria Chicone

et al.

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Cited by 2 publications

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“…We read with great interest the case report of Pagano et al . [ 1 ] on use of the KingVision videolaryngoscope (VL) in prone position. This case is further proof of the usefulness of VLs in specific condition intubations.…”

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confidence: 99%

“…These are for example Ambu Aura Gain, Air-Q or iLTS-D. LMA Supreme can be used as it has a second seal but in case of need for intubation the Aintree intubation catheter has to used, which complicates the procedure. As for VLs it seems that use of channeled VLs is better in those circumstances (for example AirTraq or KingVision) [ 1 , 3 , 4 ]. However, the provider must be an expert in VL intubation to attempt it in the patient’s prone position.…”

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confidence: 99%

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Algorithm for management of sudden unexpected extubation in patient positioned in prone position

Gaszyński¹

2020

ait

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We read with great interest the case report of Pagano et al. [1] on use of the KingVision videolaryngoscope (VL) in prone position. This case is further proof of the usefulness of VLs in specific condition intubations. There are several papers confirming that VLs can be used for intubation in prone position. We would like to discuss a life-threating situation during general anesthesia such as sudden unexpected extubation in a patient positioned in prone position for example for spine surgery. In this case usually surgical area was covered and the patient has to be positioned in supine position for reintubation. Several published papers suggest that in this case other action can be performed: use of supraglottic devices (SAD) is well described [2] and use of VLs is also considered as a safe and effective approach [3]. Our clinical experience confirms that thesis. We performed several elective airway management procedures in patients positioned in prone position using SAD and VLs with great success (Figures 1 and 2) with no complications and mean time to achieve ventilation

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Algorithm for management of sudden unexpected extubation in patient positioned in prone position

Gaszyński¹

2020

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Awake Prone Positioning in Nonintubated Patients With Acute Hypoxemic Respiratory Failure

Fusi

Bulleri

Villa

et al. 2023

Critical Care Nurse

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Background Awake prone positioning research focuses primarily on improving oxygenation and reducing intubation and mortality rates. Secondary outcomes concerning patient safety have been poorly addressed. Objective To summarize current evidence on the frequency of adverse events during awake prone positioning and the effects on patients’ safety, comfort, and tolerance. Methods This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. MEDLINE/PubMed and CINAHL databases were the primary sources for the systematic search. Results The review included 19 original studies involving 949 patients who underwent awake prone positioning. No major complications such as death, severe respiratory compromise, or hemodynamic disease were reported. Ten studies reported the following secondary adverse events related to awake prone positioning: skin breakdown (1%-6% of patients), pain (12%-42%), discomfort (35%-43%), vomiting (2%-7%), intolerance (3%-47%), and vascular catheter dislodgment (5%). The duration of awake prone positioning sessions varied widely (0.3-19 hours). Seven studies reported that nurses helped patients during prone positioning maneuvers, including monitoring and surveillance, and 3 studies reported patients placing themselves in the prone position. In 6 studies light or moderate sedation was employed in the procedures. Conclusions Awake prone positioning was not related to cardiorespiratory consequences but was associated with pain, intolerance, discomfort, and patients’ refusal. Patients should receive education regarding awake prone positioning to improve their acceptance. Health care professionals should optimize pain control, communication, patient comfort, patient adherence, and correct positioning.

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KingVision® and dexmedetomidine for opioid-free awake intubation in a patient with Klippel-Feil syndrome for complex percutaneous nephrolithotomy in a prone position: a case report

Cited by 2 publications

References 13 publications

Algorithm for management of sudden unexpected extubation in patient positioned in prone position

Algorithm for management of sudden unexpected extubation in patient positioned in prone position

Awake Prone Positioning in Nonintubated Patients With Acute Hypoxemic Respiratory Failure

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