Endotracheal intubation of an awake patient with the diagnosis of Ankylosing Spondylitis

Authors

Keywords:

airway management, rapid sequence induction and intubation, spondylitis ankylosing.

Abstract

Introduction: Ankylosing spondylitis is a disease that affects the axial skeleton with the participation of the sacroiliac joints and causes the progressive formation of intervertebral syndesmophytes. These patients are considered to have difficult airways.
Objective: To present a patient with a diagnosis of Ankylosing Spondylitis and difficult airway, scheduled for bilateral total hip prosthetic replacement under general anesthesia.
Clinical Case: 48-year-old male with ankylosing spondylitis, dilated cardiomyopathy, essential arterial hypertension, moderate chronic multifactorial anemia, who required scheduled surgical intervention for bilateral total hip replacement due to osteoarthrosis in both joints. With a III classification of the American Society of Anesthesiology, the procedure was performed in two surgical stages. For the anesthetic approach, endotracheal intubation was performed with the patient awake with prior psychological preparation. Local anesthetic (lidocaine) was used for pharyngeal micronebulization with a face mask, block of the superior laryngeal nerves, and transtracheal block for intubation with a flexible fiberoptic bronchoscope. Due to the risk of displacement of the prosthesis when changing position, the procedure was repeated three months later.
Conclusions: Successful endotracheal intubation of an awake patient with a difficult airway is shown.

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Author Biographies

Yudiel González Álvarez, Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Yissel Fernández Serrat, Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Isel Vera Díaz, Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba.

Junior Vega Jiménez, 1Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba. 2Universidad de Ciencias Médicas de Matanzas. Matanzas, Cuba.

1Hospital Militar "Dr. Mario Muñoz Monroy". Matanzas, Cuba. 2Universidad de Ciencias Médicas de Matanzas. Matanzas, Cuba.

Lisneybi Gonzalez Gonzalez, Universidad de Ciencias Médicas de Matanzas. Matanzas, Cuba.

Universidad de Ciencias Médicas de Matanzas. Matanzas, Cuba.

References

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Published

2024-09-07

How to Cite

1.
González Álvarez Y, Fernández Serrat Y, Vera Díaz I, Vega Jiménez J, Gonzalez Gonzalez L. Endotracheal intubation of an awake patient with the diagnosis of Ankylosing Spondylitis. Rev Cubana Med Milit [Internet]. 2024 Sep. 7 [cited 2025 Jan. 10];53(3):e024056756. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/56756

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Section

Case Presentation

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