ABSTRACT : airway management in a patient of anticipated difficult airway

METHODS : .Airway examination;Mouth opening ~1finger, Mallampatti grading could not be assessed.Routine investigations-normal.Written informed consent taken and difficult airway cart kept ready.intubation planned using direct laryngoscopy with RSI technique.0n table-airway preparation by Xylocard nebulisation and xylocard viscous gargles .Inj.Ramosetron 0.3mg i.v,Midazolam 1mg i.v,Glycopyrrolate 0.2mg i.v,Fentanyl 40mg iv administered.Pre-oxygenated with 100% oxygen for 3 min. Induced with Inj.Propofol 1mg/kg body wt.Awake laryngoscopy done. Cormack-Lehane grade 2-3 noted with oedema around epiglottis.Injsuccinyl choline 50 mg iv administered and Intubated using tube exchanger with 7.0mm ID cuffed portex tube.

RESULTS : Patient Intubated using tube exchanger with 7.0mm ID cuffed portextube.Placement confirmed by auscultation and capnography. Intra-op period uneventful.Aftersurgery,patientextubated.Post-op period uneventful.

CONCLUSIONS : Thorough pre-operative assessment, planning,adequate preparation resulted in successful outcome in this case.