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Updated: May 3, 2026
04:46
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
21.4K
[Two patients with CICV (cannot intubate cannot ventilate) rescued by cricothyrotomy]
Kuniko Morishima1, Satoshi Kurita1, Yoshihiro Yamama1
1Department of Anesthesia, Osaka Kosei-nenkin Hospital, Osaka 553-0003.
Masui. the Japanese Journal of Anesthesiology
|February 7, 2014
Summary
Cricothyrotomy tubes safely managed two patients with postoperative upper airway obstruction after cervical fusion surgery. This technique facilitated successful re-intubation, highlighting its utility in difficult airway scenarios.
Area of Science:
- Anesthesiology
- Otolaryngology
- Surgical Critical Care
Background:
- Postoperative upper airway obstruction is a rare but serious complication following cervical spine surgery.
- Pharyngolaryngeal edema and cervical hematoma can compromise the airway after occipito-cervical or anterior cervical fusion.
Observation:
- Two patients developed immediate postoperative upper airway obstruction after cervical fusion procedures.
- One patient had suspected pharyngolaryngeal edema post-posterior occipito-cervical fusion, while the other experienced dyspnea and neck swelling due to hematoma after anterior cervical fusion.
Findings:
- Cricothyrotomy tubes (Mini-Trach II) were utilized to establish an emergency airway in both patients.
- Assist-ventilation via the cricothyrotomy tubes enabled successful re-intubation in both cases.
Implications:
- Cricothyrotomy, when performed by trained professionals, offers a safe and effective method for managing difficult airways in the postoperative setting.
- This case series suggests that cricothyrotomy can be a valuable tool for stabilizing patients with acute upper airway compromise after cervical spine surgery.
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