EMERGENCY RETROGRADE INTUBATION IN MANDIBULAR ABSESS WITH DIFFICULT TO INTUBATE
Baginda Aflah (a*), M. Budi Kurniawan (b), Iwan Fuadi (b), Erwin Pradian (b), Suwarman (b), Reza W. Sudjud (b)

(a) Department of Anesthesiology and Intensive Therapy,
Faculty of Medicine, Padjadjaran University
(b) Dr. Hasan Sadikin General Hospital Bandung

Abstract

Introduction: Fiberoptics are the main choice in difficult intubation cases but they are still constrained by the availability and difficulty of operating the equipment. Retrograde intubation is an old technique but can be an option in difficult to intubate cases.

Case: Male 50 years old, BMI 21.5 kg / m2 planned to have evacuate mandibular abscess operation in emergency setting. Difficult airway is obtained on patient by the presence of the mouth not being able to open even after administration of analgesia and sedation making laryngoscopy is impossible. In the absence of fiberoptic availability. Then it was decided to perform an emergency retrograde intubation by wire guidance through abocath insertion of the cricothyroid membrane. The operation went successful and at the end of the operation patient was extubated.

Discussion: The retrograde intubation technique can be easy and minimally invasive alternative in limited facilities setting. Retrograde intubation can be performed blindly without visualizing the airway.

Keywords: Retrograde intubation, difficult airway, difficult intubation

Topic: Update Emergency Assesment and Management