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Case Report: Double Visualization Intubation Strategy for Patients With Ankylosing Spondylitis
Wei-Can Chen1, Shu Lin1,2,3, He-Fan He1
1Department of Anaesthesiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
Frontiers in Medicine
|April 4, 2022
Summary
Severe ankylosing spondylitis presents airway management challenges. A double visual intubation strategy using a video laryngoscope and lighted stylet successfully facilitated endotracheal intubation in a difficult case.
Area of Science:
- Anesthesiology
- Rheumatology
- Critical Care Medicine
Background:
- Ankylosing spondylitis is an autoimmune disease affecting the axial skeleton.
- Cervical spine rigidity in ankylosing spondylitis poses significant airway management challenges.
- Difficult intubation is a common concern in patients with severe ankylosing spondylitis.
Observation:
- A 31-year-old patient with severe ankylosing spondylitis presented with severely restricted neck mobility.
- Standard video laryngoscopy alone was insufficient for tracheal intubation.
- A combined approach using video laryngoscopy and a lighted stylet was employed.
Findings:
- The video laryngoscope provided visualization, while the lighted stylet guided endotracheal tube placement.
- This double visual intubation strategy successfully navigated the restricted airway.
- The oropharynx was adequately opened for rapid tracheal tube insertion below the epiglottis and into the glottis.
Implications:
- This technique offers a viable solution for endotracheal intubation in patients with severe ankylosing spondylitis and difficult airways.
- It highlights the utility of combining video laryngoscopy with lighted stylet intubation when initial laryngoscopy fails.
- Successful airway management in these complex patients is crucial for patient safety and outcomes.
