Retrograde Endotracheal Intubation Using a Guide Wire in a Pediatric Patient.
10.4097/kjae.1990.23.5.807
- Author:
Kyu Dae LEE
1
;
Jae Hyun SUH
;
Seung Nyun KIM
Author Information
1. Department of Anesthesiology, Catholic University Medical College, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Retrograde intubation;
Guide wire;
Pediatric
- MeSH:
Anesthesia;
Ankylosis;
Auscultation;
Catheters;
Child;
Droperidol;
Electrocardiography;
Halothane;
Humans;
Intubation, Intratracheal*;
Larynx;
Male;
Masks;
Membranes;
Needles;
Nitrous Oxide;
Oxygen;
Palpation;
Pharynx;
Physical Examination;
Punctures;
Syringes;
Temporomandibular Joint;
Thiopental;
Thorax;
Trachea
- From:Korean Journal of Anesthesiology
1990;23(5):807-810
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An 8-year-old male with ankylosis of both temporomandibular joints was scheduled for an elective condylectomy. Physical examination revealed a relatively healthy appearing child, weighing 25 kg, with 5-7mm of maximal oral opening. The EKG, chest x-ray and laboratory data were within normal limits. An attempt at local infiltration after injection of droperidol 2.5 mg for retrograde technique was unsuccessful. Subsequently, anesthesia was induced with thiopental, halothane, nitrous oxide and oxygen via a mask. The cricothyroid membrane was punctured with an 18 gauge Touhy needle. After confirmation of the intratracheal position by aspiration of air into a fluid filled syringe, a flexible guide wire tip of CVP catheter (VYGON) was threaded via this needle superiorly into the posterior pharynx through the larynx. After introduction of the guide wire into right naris, the nasotracheal tube was threaded over the wire, and the tip of the tube in the trachea at the site of the cricothyroid membrane puncture was confirmed by palpation and visual inspection. The nasotracheal tube was advaned further into the trachea after removal of the guide wire. Auscultation confirmed appropriate intratracheal placement.
