Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2007  |  Volume : 51  |  Issue : 2  |  Page : 148

Cricothyrotomy can be hazardous in a difficult airway scenario


M.D., Resident Medical Officer/ Clinical Tutor, Department of Anaesthesiology, N. R. S. Medical College, Kolkata, West Bengal, India

Correspondence Address:
Reema Ray
75/2, Harish Chatterjee Street, Bhowanipore, Kolkata, West Bengal- 700025
India
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Source of Support: None, Conflict of Interest: None


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Difficult and compromised airway poses a significant challenge to the anaesthesiologist. The following is a report of management of a case of difficult airway caused by injury of a prior deliberate acid ingestion. A previous uneventful anaesthetic course gave us a false sense of security while proceeding with the next surgical procedure under anaesthesia. After administration of neuromuscular blocking agent, mask ventilation became increasingly difficult and under direct laryngoscopy, visualization of glottis revealed gross fibrosis with no opening visible at all. It was a 'cannot intubate, cannot ventilate (CICV)' scenario. Percutaneous transtracheal jet ventilation (PTJV) also could not be set up as canula could not be negotiated. Surgical ('stab') cricothyroidotomy allowed rapid restoration of ventilation and oxygenation in this CICV situation but not without its complications and compromised airway was imminent. Surgical airway in the form of definite tracheostomy offered the only solution and complications averted.


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