The anesthetic goals in patientswith subglottic stenosis posted for tracheal reconstruction are establishing an adequate gas exchange & allowing good surgical accessand Airway exchange catheters can be used for oxygenation and ventilation in them.

Case report : 51 years old male, smoker, alcoholic and COPD patient, with subglottic stenosis following intubation and ventilation for 8 days for OP Compound poisoning was posted for resection and reconstruction under ASA grade 3 risk with plan of airway block & GA. ECG, pulse oximetry, NIBPandEtco2were monitored. Preoxygenated, premedicated and airway block given with patient breathingO2spontaneously through face mask.Under direct laryngoscopyeven size 5 IDendotracheal tube could not be passed beyond the vocal cords.Airway Exchange Catheter with an inner diameter of 1.6mm was used to intubate the trachea and ventilation manually assisted. As saturation was not maintaining,airway exchange catheter was removed.

Uncuffed ETT size 4.5tube was kept just above the vocal cordsand Tracheostomy was done distal to tracheal stenosis and 8.5mm ID flexometallic ETT passed through tracheal stoma.Induced and maintained on GA. resection and anastomosis doneafter removal of the in situ tube, ventilating with airway exchange catheter first then with 7.5 mm ID cuffed ETT but cuff not inflated.Patient electively ventilated for 48 hrs. Then extubated.

Conclusion: Airway exchange catheter can be used for oxygen insufflation or manual ventilation in patients with critical tracheal stenosis for safe and efficient gas exchange,during tracheotomy and during resection.