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Rev Esp Anestesiol Reanim ; 62(9): 536-9, 2015 Nov.
Article in Spanish | MEDLINE | ID: mdl-25687944

ABSTRACT

Lennox-Gastaut syndrome is a childhood epileptic encephalopathy, and is characterized by frequent and difficult to treat seizures associated with mental retardation. The case is presented of a 21 year-old male with Lennox-Gastaut syndrome, with bilateral cervical facet joint dislocation fracture at C6-C7 and spinal canal compression as a result of a fall during a seizure. In this case the management of the difficult airway expected in an awake and uncooperative patient, with cervical spinal cord injury is described. An airway management strategy was proposed, that allowed a rapid and safe airway control with the best possible tolerance and maintaining the neck immobilised, so as not to increase neurological injury. Within this strategy, plan A was defined as inhalation induction with sevoflurane to maintain spontaneous breathing and tracheal intubation with Airtraq®. We believe that the Airtraq® video laryngoscope with inhalational induction with sevoflurane is a valid and effective alternative in the management of expected difficult airway.


Subject(s)
Airway Management/methods , Anesthesia, Inhalation/methods , Cervical Vertebrae , Joint Dislocations/etiology , Laryngoscopes , Lennox Gastaut Syndrome/complications , Neck Injuries/etiology , Zygapophyseal Joint/injuries , Accidental Falls , Airway Management/instrumentation , Anesthetics, Inhalation/administration & dosage , Braces , Cervical Vertebrae/surgery , Emergencies , Humans , Intubation, Intratracheal , Joint Dislocations/surgery , Male , Methyl Ethers/administration & dosage , Neck Injuries/surgery , Sevoflurane , Spinal Cord Compression/etiology , Spondylolisthesis/etiology , Spondylolisthesis/surgery , Young Adult , Zygapophyseal Joint/surgery
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