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Jaw thrust can deteriorate upper airway patency

B S von Ungern-Sternberg1, T O Erb, F J Frei

  • 1Department of Anesthesia, University Children's Hospital Basel, Basel, Switzerland. bvonungern@uhbs.ch

Acta Anaesthesiologica Scandinavica
|March 22, 2005
PubMed

Insights

Maintaining a clear airway during anesthesia is crucial for children. In rare cases, the jaw thrust maneuver can worsen upper airway obstruction in children with neck masses.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Otolaryngology

Background:

  • Upper airway obstruction is a common concern in pediatric patients undergoing anesthesia or sedation.
  • Children have a higher metabolic rate and lower oxygen reserves, making airway compromise particularly dangerous.

Observation:

  • Two pediatric cases are presented where cervical masses exacerbated upper airway obstruction during anesthesia induction.
  • The jaw thrust maneuver, typically used to open airways, worsened obstruction in these patients.

Findings:

  • The jaw thrust maneuver caused medial displacement of lateral tumorous tissues in the neck.
  • This displacement led to significant narrowing of the pharyngeal airway, increasing obstruction.

Implications:

  • Clinicians should exercise caution when using the jaw thrust maneuver in pediatric patients with cervical masses.
  • Alternative airway management strategies may be necessary to avoid exacerbating obstruction in these specific cases.

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