Airway Management of a Neck-Burned Child with Mc-Grath Series 5 Videolaryngoscope and Gum Elastic Bougie

Abstract

Background: Anesthetic management of a neck-burned child presents many problems but especially airway difficulties are characteristic. In addition to differences between pediatric and adult airway, concomitant challenges of postburn sternomental contractures may lead to the catastrophic outcomes. Videolaryngoscope is an alternative intubation device which improves laryngeal view and does not require a direct glottic view. Gum elastic bougie is also a well-known and valuable aid for management of difficult intubation. Case Report: We presented a successful airway management of a 10 year old boy underwent post-burn contracture releasing surgery for his neck and left upper extremity with Mc-Grath Series 5 videolaryngoscope and gum elastic bougie. The patient had limitation in neck mobility because of severe burn contracture (patient’s neck was contracted in the flexed position, his chin and lower lip was restrained down to the anterior trunk) with lack of any respiratory disorder. After preoxygenation we administered anaesthesia induction. Mask ventilation was failed because of excessive gas leak. So we inserted laringeal mask airway without significant desaturation. After providing adequate ventilation we administered muscle relaxant. After two unsuccessful attempts we performed intubation with Mc-Grath Series 5 videolaryngoscope and gum elastic bougie. We confirmed correct tube placement via capnograph. Conclusion: Concurent use of Mc-Grath Series 5 videolaryngoscope and gum elastic bougie in management of pediatric difficult airway is suitable as an alternative technique.