Anaphylaxis Induced Refractory Bronchospasm in “Anticipated Difficult Airway” Situation: Combined Approach of Fibre Optic Laryngoscope Guided Endotracheal Tube Placement via the Nasal Route and Sevoflurane during Rapid Sequence Induction

We wish to report here how we tackled anaphylaxis-induced bronchospasm in an ‘anticipated difficult airway’ situation using a novel combination of established practices. Our patient was morbidly obese and had both predicted difficult mask ventilation as well as predicted difficult intubation in the...

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Bibliographic Details
Main Authors: Sanjay Kumar, Amrita Bhattacharya, Sandeep Khuba, Nupur Gupta, Rama Kant
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-07-01
Series:NMO Journal
Subjects:
Online Access:https://journals.lww.com/10.4103/JNMO.JNMO_20_24
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Summary:We wish to report here how we tackled anaphylaxis-induced bronchospasm in an ‘anticipated difficult airway’ situation using a novel combination of established practices. Our patient was morbidly obese and had both predicted difficult mask ventilation as well as predicted difficult intubation in the immediate pre-induction period. He developed bronchospasm, which we attempted to treat as per the established protocols. All of these failed, and we then proceeded to insert a 7-mm endotracheal tube nasally, its tip lying just above the epiglottis (via fibre-optic guidance). Sevoflurane vapours and oxygen were delivered through it, and this gradually relieved the bronchospasm and improved the patient’s oxygenation.
ISSN:2348-3806
2950-5933