Ankylosing spondylitis. The case for awake intubation.

Area of Science:

• Anesthesiology
• Rheumatology
• Surgical Management

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
• Long-standing AS can lead to severe spinal and cervical fusion, significantly impacting airway accessibility.
• Surgical and anesthetic management in AS patients requires careful consideration of potential airway complications.

Observation:

• Review of surgical and anesthetic literature highlights major problems in long-standing ankylosing spondylitis.
• Four case studies illustrate specific upper airway challenges encountered in AS patients.
• Difficulties in airway management are a critical concern for anesthesiologists treating AS.

Findings:

• The study emphasizes the significant risks associated with airway management in patients with advanced ankylosing spondylitis.
• Awake intubation techniques are identified as a crucial strategy to mitigate airway complications.
• Successful anesthetic management hinges on anticipating and addressing AS-related airway limitations.

Implications:

• Highlights the importance of pre-operative airway assessment in ankylosing spondylitis patients.
• Advocates for the adoption of awake intubation as a preferred method in select AS cases.
• Informs anesthetic protocols to improve patient safety and surgical outcomes in rheumatologic conditions.