Inhaled induction and topical anesthesia of the airway guided with C-MAC d-Blade videolaryngoscope in a myasthenia gravis patient and difficult airway
Keywords:
Myasthenia Gravis, Airway Management, Laryngoscopy, Neuromuscular Blocking, Ventilation
Abstract
This is a case of a patient diagnosed with myasthenia gravis and clinical predictors of difficult intubation and ventilation undergoing emergency surgery for eventroplasty and bowel resection. The patient was successfully intubated asleep, with no neuromuscular relaxation, using a C-MAC videolaryngoscope and difficult intubation d-Blade, following inhaled induction and topical anesthesia of the airway.
We do want to stress the clinical value of videolaryngoscopy in patients with positive predictors of difficult intubation, the applicability of Sevoflurane for the maintenance of spontaneous ventilation in a patient asleep, as well as the use of Sugammadex for reversal of neuromuscular block in a myasthenia patient.
References
1. Niforopoulou P, Pantazopoulos I, Demestiha DE, Koudouna E, Xanthos T. Video-laryngoscopes in the adult airway management: a topical review of the literature. Acta Anaesthesiol Scand. 2010;54:1050-61.
2. American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003;98:1269-77.
3. Valero R, Mayral V, Massó E, López A, Sabaté S, Villalonga R, et al. Evaluación y manejo de la vía aérea difícil prevista y no prevista: adopción de guías de práctica. Rev Esp Anestesiol Reanim. 2008;55:563-70.
4. Blichfeldt-Lauridsen L, Hansen BD. Anaesthesia and myasthenia gravis. Acta Anaesthesiol Scand. 2012;56:17-22.
5. Macintyre PA, Ansari KA. Sevoflurane for predicted difficult tracheal intubation. Eur J Anesthesiol. 1998;15:462-6.
6. Martín-Larrauri R, Gilsanz F, Rodrigo J, Vila P, Ledesma M,Casimiro C. Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane. Eur J Anesthesiol. 2004;21:265-71.
7. Crosby ET, Cooper RM, Douglas MJ, Doyle DJ, Hung OR, Labrecque P, et al. The unanticipated difficult airway with recommendations for management. Can J Anaesth. 1998;45:757-76.
8. Unterbuchner C, Fink H, Blobner M. The use of sugammadex in a patient with myasthenia gravis. Anaesthesia. 2010;65:302-5.
9. Challan Belval A, Tramoni G, Vedrinne JM, Olagne E, Vigneron M. The use of sugammadex in a patient with myasthenia gravis. Ann Fr Anesthesiol Reanim. 2012;31:569-70.
10. De Boer HD, van Egmond J, Driessen JJ, Booij LH. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex. Rev Esp Anestesiol Reanim. 2010;57:181-4.
11. Jungbauer A, Schumann M, Brunkhorst V, Borgers A, Groeben H. Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients. Br J Anaesth. 2009;102:546-50.
12. Maasen R, Lee R, Hermans B, Marcus M, van Zundert A. A comparison of three videolaryngoscopes: the Macintosh laryngoscope blade reduces, but does not replace, routine stylet use for intubation in morbidly obese patients. Anesth Analg. 2009;109:1560-5.
13. McElwain J, Malik MA, Harte BH, Flynn NM, Laffey JG. Comparison of the C-MAC videolaryngoscope with the Macintosh, Glidescope and Airtraq laryngoscopes in easy and difficult laryngoscopy scenarios in manikins. Anaesthesia. 2010;65:483-9.
14. Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K, et al. First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation. Anesth Analg. 2011;112:382-5.
15. Van Zundert A, Hermans B, Kuczkowski K. Successful use of a videolaryngoscope in a patient with carcinoma of the oropharynx and obstructed airway. Minerva Anestesiol. 2009;75:475-6.
16. Pott LM, Murray WB. Review of video laryngoscopy and rigid fiberoptic laryngoscopy. Curr Opin Anaesthesiol. 2008;21:750-8.
17. Aziz MF, Dillman D, Fu R, Brambrink AM. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. Anesthesiology. 2012;116:629-36.
2. American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003;98:1269-77.
3. Valero R, Mayral V, Massó E, López A, Sabaté S, Villalonga R, et al. Evaluación y manejo de la vía aérea difícil prevista y no prevista: adopción de guías de práctica. Rev Esp Anestesiol Reanim. 2008;55:563-70.
4. Blichfeldt-Lauridsen L, Hansen BD. Anaesthesia and myasthenia gravis. Acta Anaesthesiol Scand. 2012;56:17-22.
5. Macintyre PA, Ansari KA. Sevoflurane for predicted difficult tracheal intubation. Eur J Anesthesiol. 1998;15:462-6.
6. Martín-Larrauri R, Gilsanz F, Rodrigo J, Vila P, Ledesma M,Casimiro C. Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane. Eur J Anesthesiol. 2004;21:265-71.
7. Crosby ET, Cooper RM, Douglas MJ, Doyle DJ, Hung OR, Labrecque P, et al. The unanticipated difficult airway with recommendations for management. Can J Anaesth. 1998;45:757-76.
8. Unterbuchner C, Fink H, Blobner M. The use of sugammadex in a patient with myasthenia gravis. Anaesthesia. 2010;65:302-5.
9. Challan Belval A, Tramoni G, Vedrinne JM, Olagne E, Vigneron M. The use of sugammadex in a patient with myasthenia gravis. Ann Fr Anesthesiol Reanim. 2012;31:569-70.
10. De Boer HD, van Egmond J, Driessen JJ, Booij LH. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex. Rev Esp Anestesiol Reanim. 2010;57:181-4.
11. Jungbauer A, Schumann M, Brunkhorst V, Borgers A, Groeben H. Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients. Br J Anaesth. 2009;102:546-50.
12. Maasen R, Lee R, Hermans B, Marcus M, van Zundert A. A comparison of three videolaryngoscopes: the Macintosh laryngoscope blade reduces, but does not replace, routine stylet use for intubation in morbidly obese patients. Anesth Analg. 2009;109:1560-5.
13. McElwain J, Malik MA, Harte BH, Flynn NM, Laffey JG. Comparison of the C-MAC videolaryngoscope with the Macintosh, Glidescope and Airtraq laryngoscopes in easy and difficult laryngoscopy scenarios in manikins. Anaesthesia. 2010;65:483-9.
14. Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K, et al. First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation. Anesth Analg. 2011;112:382-5.
15. Van Zundert A, Hermans B, Kuczkowski K. Successful use of a videolaryngoscope in a patient with carcinoma of the oropharynx and obstructed airway. Minerva Anestesiol. 2009;75:475-6.
16. Pott LM, Murray WB. Review of video laryngoscopy and rigid fiberoptic laryngoscopy. Curr Opin Anaesthesiol. 2008;21:750-8.
17. Aziz MF, Dillman D, Fu R, Brambrink AM. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. Anesthesiology. 2012;116:629-36.
How to Cite
1.
Galán Gutiérrez JC, Charco Mora P, Sadarangani Pestana A. Inhaled induction and topical anesthesia of the airway guided with C-MAC d-Blade videolaryngoscope in a myasthenia gravis patient and difficult airway. Colomb. J. Anesthesiol. [Internet]. 2013 Oct. 1 [cited 2024 Apr. 18];41(4):287-90. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/671
Downloads
Download data is not yet available.
Published
2013-10-01
How to Cite
1.
Galán Gutiérrez JC, Charco Mora P, Sadarangani Pestana A. Inhaled induction and topical anesthesia of the airway guided with C-MAC d-Blade videolaryngoscope in a myasthenia gravis patient and difficult airway. Colomb. J. Anesthesiol. [Internet]. 2013 Oct. 1 [cited 2024 Apr. 18];41(4):287-90. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/671
Issue
Section
Case Report / Case Series
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
