CASE REPORTS   Free access

Minerva Anestesiologica 2010 May;76(4):369-72

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

The use of an i-gel supraglottic airway for the airway management of a patient with subglottic stenosis: a case report

Donaldson W. ¹, Michalek P. ^{2, 3} ✉

¹ Specialist Registrar in Anesthetics; ² Consultant Anesthetist, Department of Anesthetics, Antrim Area Hospital, Antrim, UK; ³ Anesthesia and Intensive Care, Charles University, Prague, Czech Republic

The airway management of patients with subglottic stenosis poses many challenges for the anesthesiologist. Although many anesthesiologists would prefer the use of a narrow endotracheal tube in this patient population, the use of laryngeal mask airways has also been described. We report the case of a patient who was managed using an i-gel supraglottic airway due to a difficulty with inserting an endotracheal tube during a previous procedure. A 47-year old woman with an ASA (American Society of Anesthesiologists) score of I was scheduled to undergo a laparoscopic cholecystectomy. An i-gel supraglottic airway was inserted without difficulty, provided a good seal, and allowed for controlled ventilation with acceptable peak pressures throughout the operation, including during pneumoperitoneum. Furthermore, the vocal cords were successfully visualized using a fiberscope, allowing the possibility of eventual fiberoptic intubation, if it had been necessary. The presence of subglottic stenosis was also confirmed using the fiberscope. Thus, the i-gel airway device has multiple features that makes it suitable for use in situations where a narrow endotracheal tube is inadvisable or too difficult to use.