Lung Isolation in a Patient with Sub Mucosal Fibrosis: Anaesthesiologist Perspective

Abstract

21-year-old male was diagnosed to have left lower lobe hydatid cyst and was planned for lobectomy. He had a mouth opening of 2 cm due to sub mucosal fibrosis. Anaesthesia was induced and adequate mask ventilation was assured. Check laryngoscopy was not possible. But Macintosh blade was used to lateralize the tongue to left side to create space within the oral cavity and also acted like a bite block. Then a bougie was placed in the trachea under the guidance of nasal fibre optic bronchoscope. Then a uninvent tube of size 6.5 mm ID was threaded over the bougie atraumatically under FOB guidance. Then the bougie was withdrawn and FOB was passed through uninvent and the bronchial blocker was placed in the left main bronchus under vision. The tube was firmly secured and excellent lung isolation was achieved.