A simple method to deliver pharyngeal anesthesia in syndromic infants prior to awake insertion of the intubating laryngeal airway
To the Editor,
Infants with a craniofacial abnormality who are potentially difficult to mask ventilate may benefit from awake placement of a supraglottic device to aid in tracheal intubation.1 Moreover, in some syndromic infants, severe upper airway obstruction may be present at birth, which often requires a mandibular advancement procedure or a tracheostomy.2 As these procedures require general anesthesia, clinicians may be hesitant to proceed with induction of anesthesia until upper airway obstruction is relieved. Options with the potential to alleviate airway obstruction prior to induction of anesthesia include: a change in position of the patient from supine to lateral or prone, placement of a naso-pharyngeal airway,3 or awake insertion of a supraglottic airway device.1 In this clinical scenario, the primary advantage of a supraglottic device is to relieve upper airway obstruction while providing a reliable conduit for tracheal intubation. Awake placement of the laryngeal mask airwa
- Asai T, Nagata A, Shingu K. Awake tracheal intubation through the laryngeal mask in neonates with upper airway obstruction. Paediatr Anaesth 2008; 18: 77-80.
- Nargozian C. The airway in patients with craniofacial abnormalities. Paediatric Anaesth 2004; 14: 53-9. CrossRef
- Holm-Knudsen R, Eriksen K, Rasmussen LS. Using a nasopharyngeal airway during fiberoptic intubation in small children with a difficult airway. Paediatr Anaesth 2005; 15: 839-45. CrossRef
- Jagannathan N, Roth AG, Sohn LE, Park TY, Amin S, Suresh S. The new air-Q intubating laryngeal airway for tracheal intubation in children with anticipated difficult airway: a case series. Paediatr Anaesth 2009; 19: 618-22.
- Jagannathan N, Sohn LE, Suresh S. Glossopharyngeal nerve blocks for awake laryngeal mask airway insertion in an infant with Pierre-Robin syndrome: can a glidescope come to the rescue? Paediatr Anaesth 2009; 19: 189-90. CrossRef
- A simple method to deliver pharyngeal anesthesia in syndromic infants prior to awake insertion of the intubating laryngeal airway
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Volume 57, Issue 12 , pp 1138-1139
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors