کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
2741705 | 1148552 | 2008 | 4 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Upper Airway Obstruction After Cervical Spine Fusion Surgery: Role of Cervical Fixation Angle Upper Airway Obstruction After Cervical Spine Fusion Surgery: Role of Cervical Fixation Angle](/preview/png/2741705.png)
Upper airway obstruction is one of the life-threatening events in cervical spine surgery. The risk is particularly great during the period immediately after operation. We present the case of a 56-year-old female with breast cancer and metastasis to the cervical spine. The surgical procedure involved C2-C3 laminectomy, posterior fixation (C0-C5), and C2 neurectomy. Tracheal extubation was carried out in the intensive care unit, and upper airway obstruction immediately followed. Emergency cricothyrotomy was performed under well-managed ventilation with a laryngeal mask after several failed intubation attempts. Over-flexion of the cervical spine fixation and severe prevertebral soft tissue swelling were the most probable causes of upper airway obstruction. With a well-adjusted angle for fixation of the cervical spine under fluoroscopic guidance before the procedure, such a surgical mishap could be avoided. Reintubation with a fiberscope might be considered first, and sustaining intubation for 2-3 days postoperatively could be safer in such high risk patients.
Journal: Acta Anaesthesiologica Taiwanica - Volume 46, Issue 3, September 2008, Pages 134-137