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Updated: Aug 16, 2026

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
Awake tracheal intubation with the intubating laryngeal mask in a patient with diffuse idiopathic skeletal
1Department of Anaesthesia, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, UK.
Abstract:
Diffuse idiopathic skeletal hyperostosis, otherwise known as Forestier's disease or ankylosing hyperostosis, is a relatively common condition that is distinguished from ankylosing spondylitis by the relative preservation of spinal function and the characteristic 'candle flame' lipping of the vertebrae. We report a patient with this condition and a well-recorded history of impossible intubation who presented for emergency laparotomy. The patient was intubated awake using the intubating laryngeal mask and sedation and anaesthesia were provided by a target-controlled infusion of propofol.
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