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Year : 2010  |  Volume : 54  |  Issue : 4  |  Page : 356-357 Table of Contents     

Difficulty beyond intubation

Department of Anaesthesia, Vinayaka Missions Medical College, Karaikal, Pondicherry, India

Date of Web Publication12-Aug-2010

Correspondence Address:
Sekar Michael
CA 2, Shruthi Enclave, Dhanalakshmi Puram, Singanallur Post, Coimbatore - 641 005
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5049.68381

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How to cite this article:
Michael S. Difficulty beyond intubation. Indian J Anaesth 2010;54:356-7

How to cite this URL:
Michael S. Difficulty beyond intubation. Indian J Anaesth [serial online] 2010 [cited 2020 Oct 21];54:356-7. Available from: https://www.ijaweb.org/text.asp?2010/54/4/356/68381


A six-year-old girl was posted for a posterior pharyngeal wall tumour excision. The patient was submitted for preanaesthetic review with chest X-ray as well as X-ray of head and neck. There was no gross abnormality in either and no history suggestive of sleep apnoea. [1] However, it was decided to induce with inhalational anaesthesia anticipating difficulty in intubation. [2] Intubation was easy only with 4.0 uncuffed instead of 6.0 cuffed endotracheal tube that is appropriate for her age group.

As the surgery was underway, there was difficulty in ventilating the child and it was found that the tube had come off as the tumour was being resected, giving a big passage larger than the existing endotracheal tube size (4.0 uncuffed). Since the field was bloody and the saturation kept falling, a cricothyroid puncture was made to oxygenate and later intubation with a 6.0 cuffed tube after clearing the bloody field.

Changing the tube with a different size, as the tumour was resected, was not spontaneous, though it was anticipated and planned for a difficult airway management. This may be a good lesson for the beginners who involve in oropharyngeal wall tumour surgeries.

   References Top

1.Namyslowski G, Scierski W, Misiolek M, Urbaniec N, Lange D. Huge retropharyngeal lipoma causing obstructive sleep apnea: A case report. Eur Arch Otorhinolaryngol 2006;263:738-40.   Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Kundra P, Hari Krishnan S. Airway management in children. Indian J Anaesth 2005;49:300-7.  Back to cited text no. 2    Medknow Journal  


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