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Anestesia Analgesia Reanimación

versión On-line ISSN 1688-1273


GRUNBERG, Gustavo. Intubación nasotraqueal con ‘videolaringoscopio artesanal’ en paciente con vía aérea dificultosa prevista. Anest Analg Reanim [online]. 2012, vol.25, n.2, pp.55-60. ISSN 1688-1273.

SUMMARY  The objective of this work was to analyze a case of expected difficult airway that required nasotracheal intubation (INT) for maxillofacial surgery, which was resolved with a traditional laryngoscope modified by the addition of a mini-camera. Female patient, 68 years of age, scheduled  for osteosynthesis of jaw and orbit with INT. History: operation of breast cancer. Heavy smoker. Traumatic brain injury 3 weeks before, with petrous bone fracture and no parenchymal injuries. Peripheral facial paralysis secondary to trauma. Examination shows: features deviation to the left, Bell's palsy, reduced mouth opening (2.5 cm), Mallampati IV, limited flexion and extension of the neck, distances are preserved. Right nostril was prepared with adrenaline solution applied with swabs. Premedication with Fentanyl 2  g/kg, preoxygenation at 100%, induction with propofol. Good permeability of right nostril was confirmed by digital examination, allowing to insert a 7.0 endotracheal tube (ETT) until passing through the turbinate bones; laryngoscopy with #3 curved blade equipped with  a 7 mm camera (7 mm USB Endoscope, Welsky Technologies Limited) at the distal tip, connected to a notebook wherein structures were visualized. No muscle relaxant was administered until intubation was completed. ETT was introduced after visualizing the vocal cords on the screen; Magill forceps were not used. Conclusion: the laryngoscope modified by the addition of a camera for visualization on a monitor screen was effective to carry out INT and manage this expected difficult airway situation.


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