Nasal Endotracheal Intubation Using a Gum-elastic Bougie and the Nasopharyngeal Airway in a Patient under Cervical Stabilization
Ueno, T.; Komasawa, N.; Nishihara, I.; Minami, T.
Masui. Japanese Journal of Anesthesiology 65(10): 1023-1025
2016
ISSN/ISBN: 0021-4892 PMID: 30358279 Document Number: 687843
Here we report a case of successful nasal endotra- cheal intubation using a gum-elastic bougie and the nasopharyngeal airway (NPA) in a patient under cervical stabilization. A 40-year-old woman was sched- uled to undergo spinal fusion surgery from the anterior approach for symptomatic cervical spondylotic myelop- athy under general anesthesia with nasal intubation. As she had paralysis and presented with numbness in her limbs, the airway was planned to be secured under cervical stabilization. After induction of anesthesia with propofol, fentanyl, and rocuronium, mask ventilation was achieved with the jaw-thrust maneuver. A gum- elastic bougie (GEB) was inserted into her nasal cavity and passed into the trachea under gentle laryngoscopy. We attempted insertion of the spiral tracheal tube (internal diameter, 7.0 mm) along the GEB, which was impossible. We then inserted NPA (internal diameter, 8.0 mm) via the GEB and dilated the cavity. After NPA removal, the spiral tube successfully progressed railing on the GEB. The operation was uneventful, and the patient was extubated in the operating room.