Tracheal intubation through Igel conduit in a child with post-burn contracture

Gupta, Richa; Wadhawan, Sonia; Bhadoria, Poonam

doi:10.4103/0970-9185.98359

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…Gupta et al [35] described a case of tracheal intubation through an i-gel in a child with a burn contracture of the anterior neck whilst Kim et al [36] described the airway management of a 4-year-old child with Goldenhar syndrome scheduled for tonsillectomy; conventional laryngoscopy was unsuccessful, but a cuffed tracheal tube was successfully passed over a fibreoptic bronchoscope inserted through the i-gel. Furthermore, the i-gel is potentially useful as an airway adjunct during cardiopulmonary resuscitation [37] and the manufacturer has now developed an 'i-gel O 2 resus pack' for such purposes (this is currently only available in adult sizes).…”

Section: Other Uses For the I-gel In Childrenmentioning

confidence: 99%

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

Smith

Bailey

2014

Anaesthesia

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SummaryWe performed a review of published literature comparing the i‐gel™ with other supraglottic airway devices in children. Sixty‐two articles were identified following a literature search; we included data from 14 randomised controlled trials and eight observational studies that compared i‐gel sizes 1–2.5 with other commonly used, equivalently‐sized, devices. The primary outcome in most studies was oropharyngeal leak pressure. In the 14 randomised trials the i‐gel performed the same as the comparator device in five trials, significantly better in eight studies (p < 0.05) and significantly worse in one (p < 0.01). Seven studies assessed fibreoptic views of the larynx through the device; two found significantly better views through the i‐gel. Three studies reported a shorter insertion time for the i‐gel, whereas two reported a longer time. Insertion success rate, gastric tube placement and complications were similar for all the devices. Seven of the eight observational studies measured average oropharyngeal leak pressures of 20–27 cmH2O and all had first‐time insertion success rates exceeding 90%. We conclude that the i‐gel is at least equivalent to other supraglottic airway devices currently available for use in children, and may enable a higher oropharyngeal leak pressure and an improved fibreoptic view of the glottis.

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Section: Other Uses For the I-gel In Childrenmentioning

confidence: 99%

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

Smith

Bailey

2014

Anaesthesia

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“…Typically, nasal route is used to introduce, although oral route too is used occasionally. [ 3 8 ] Alternatively, some airway managers get the scar released under tumescent anesthesia or ketamine before proceeding with GA and oral/nasal intubation. [ 2 ] There is a case report of resorting to tracheostomy also after scar release.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons being reduced mouth opening[ 10 ] and reduced sterno-mental space. [ 3 ] Although the inter-incisor gap (IIG) is almost always adequate in these cases,[ 8 ] [ Figure 1a ] sometimes the upper lip gets pulled down over the upper incisors to give a false sense of reduced mouth opening and IIG [ Figure 1b ]. Once that is understood and the distorted upper lip is pulled out of the way, the adequate IIG can be appreciated [ Figure 1c and Table 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are very few reports of SAD use in contracture neck and most are as an emergency option[ 10 ] or as a conduit for ETT. [ 3 8 ] There is a study where LMA and i-gel have been compared as definitive devices in cases of neck contracture but the study design, methodology, discussion, and conclusions are rather ambiguous. The study does not describe the severity of contracture or airway characteristics of the patients and seems focused on highlighting the attributes of i-gel.…”

Section: Discussionmentioning

confidence: 99%

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Pre-shaped supraglottic airway devices offer an alternative to endotracheal intubation for airway management of postburn neck contracture: A case series

Kumar¹,

Kumar²,

Kumar³

et al. 2022

J Anaesthesiol Clin Pharmacol

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Background and Aims: Moderate to severe postburn contractures (PBCs) of the neck lead to multiple areas of difficulty in airway management. Awake flexible fiberscope guided intubation with cuffed endotracheal tube (ETT) is considered the “gold standard” for securing the airway in these cases. Supraglottic airway devices (SADs), if at all used, are used either as rescue devices or as conduits for ETT. This case series looks at the possibility of using SADs as a planned airway securing device in these cases. Material and Methods: We managed 24 cases of moderate to severe PBC neck using six types of pre shaped SADs as the first choice airway device. These SADs were placed after either airway topicalization (19 cases) or general anesthesia (GA) (5 cases). Once SAD placement was confirmed, all the patients received GA and muscle relaxant. Tests for proper placement and function and fiberscopy (conducted in four cases) were performed at various times during the procedure. The SADs were removed once the patients were fully awake. Results: SADs could be placed in one attempt in all the cases. The time taken to hand over the patients to surgeons was 12–20 min. SADs maintained their proper placement and function in spite of changing airway dimensions during contracture release. The patients tolerated the SADs well right until the time they were fully awake. The SADs could be successfully removed on the operation table in all the cases. Conclusion: Pre shaped SADs secure the airway quickly and are free from the risk of intraoperative displacements and allow uneventful emergence in moderate and severe PBC neck cases and need to be considered as the first choice in these cases.

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“…We only found one case report describing fiberoptic intubation through I-gel LMA in a post-burn patient [16]. A nine year-old girl with a neck contracture limited to the anterior midline with no other parameters of difficult airway described.…”

Section: Discussionmentioning

confidence: 99%

A Case of Severe Head and Neck Post-Burn Contractures: Fiberoptic Intubation through an I-Gel Laryngeal Mask Maintaining Spontaneous Ventilation

Guimarães¹,

Real²

2015

J Anesth Clin Res

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Airway management in patients with head and neck contractures can be very challenging. Severe facial and neck scars may predict difficult mask ventilation. Difficult intubation should also be expected. We analyzed the airway management in an adolescent with severe post burn head and neck contractures. The challenges during airway approach are discussed and a comprehensive analysis regarding the option for fiberoptic intubation using an I-gel laryngeal mask as a conduit is also performed. Considering the scarce literature in this topic, the techniques described here represent an important contribute to the process of decision-making when planning the airway approach in these patients.

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Tracheal intubation through Igel conduit in a child with post-burn contracture

Cited by 6 publications

References 4 publications

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

Pre-shaped supraglottic airway devices offer an alternative to endotracheal intubation for airway management of postburn neck contracture: A case series

A Case of Severe Head and Neck Post-Burn Contractures: Fiberoptic Intubation through an I-Gel Laryngeal Mask Maintaining Spontaneous Ventilation

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Tracheal intubation through Igel conduit in a child with post-burn contracture

Cited by 6 publications

References 4 publications

A performance comparison of the paediatric i‐gel™ with other supraglottic airway devices

A performance comparison of the paediatric i‐gel™ with other supraglottic airway devices

Pre-shaped supraglottic airway devices offer an alternative to endotracheal intubation for airway management of postburn neck contracture: A case series

A Case of Severe Head and Neck Post-Burn Contractures: Fiberoptic Intubation through an I-Gel Laryngeal Mask Maintaining Spontaneous Ventilation

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A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices