Retrograde Naso-Tracheal Intubation Using a Cook Retrograde Intubation Set: A Case Report

Abstract

Endotracheal intubation in patients with limited mouth opening always remains a challenge, especially in the absence of flexible fibre optic bronchoscope. The retrograde catheter technique is an accepted option for airway management in cases where oral intubation is not possible because of limited mouth opening or not recommended because of fear of dislodgement of fracture segments or facial bones. We performed retrograde nasal intubation in a patient with complicated bilateral mandibular fracture from gunshot injury, using the Cook retrograde intubation set. This procedure was performed on a 51-year-old farmer victim of gunshot injury with communited fracture of the mandible, and consequent limited mouth opening from previous emergency surgery. Difficult airway tray, and the Cook retrograde intubation set was assembled. Retrograde nasal intubation was successfully performed under deep inhalational halothane anesthesia, with preservation of the patient’s respiratory effort, using the Cook retrograde intubation set.