The Application of a SaCoVLMTM Visual Intubation Laryngeal Mask for the Management of Difficult Airways in Morbidly Obese Patients: Case Report

Yongtao Sun,Lingling Xu,Yongle Guo,Yuelan Wang,Min Zhang,Linlin Huang

doi:10.3389/fmed.2021.763103

Abstract

We report insertion of the SaCoVLMTM in three awake morbidly obese patients (BMI 46. 7–52.1 kg/m2). The patients were given intravenous atropine and midazolam injections after entering the operating room and then inhaled an anesthetic with 2% lidocaine atomization. After SaCoVLMTM insertion while patients were awake, when the vocal cords were visualized, controlled anesthetic induction commenced with spontaneous ventilation. The entire anesthesia induction and intubation process was completed under visualization, and no adverse events such as hypoxemia occurred. No patient had an unpleasant recall of the procedure. We conclude that the SaCoVLMTM is easy to use, well tolerated and suitable for awake orotracheal intubation in patients with known difficult airways.

Highlights

Awake tracheal intubation is recommended in patients with known or predicted difficult airways [1]
A 38-years-old, 124 kg, 163 cm, BMI 46.7 kg/ m2, American Society of Anesthesiologists Classification (ASA) III level female. She had a history of 5 years hyperthyroidism and Obstructive sleep apnea (OSA) for over 10 years, abdominal hernia for over 2 years, habitual mandibular dislocation, thyroidectomy and two cesarean deliveries without any significant personal or familial past history
The tracheal intubation and the entrance of the LMA was fixed with the infusion paster, the laryngeal mask was kept to evacuate the cuff gas, and tracheal intubation was used to maintain anesthesia during the operation (Figure 2C)

Summary

INTRODUCTION

Awake tracheal intubation is recommended in patients with known or predicted difficult airways [1]. The SaCoVLMTM visible intubation laryngeal mask was independently developed in China. (Youyi Medical Instrument Co. Ltd., HangZhou, China) as an awake tracheal intubating device in patients with an anticipated difficult airway management. A 38-years-old, 124 kg, 163 cm, BMI 46.7 kg/ m2, American Society of Anesthesiologists Classification (ASA) III level female She had a history of 5 years hyperthyroidism (propylthiouracil 300 mg qd.) and Obstructive sleep apnea (OSA) for over 10 years, abdominal hernia for over 2 years, habitual mandibular dislocation, thyroidectomy and two cesarean deliveries without any significant personal or familial past history. The tracheal intubation and the entrance of the LMA was fixed with the infusion paster, the laryngeal mask was kept to evacuate the cuff gas, and tracheal intubation was used to maintain anesthesia during the operation (Figure 2C). The postoperative VAS scores were all below 3, and no complications, such as hypoxemia, nausea or vomiting, occurred

DISCUSSION

CONCLUSION

ETHICS STATEMENT