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CC BY 4.0 · Surg J (N Y) 2019; 05(04): e181-e183
DOI: 10.1055/s-0039-1700806
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Case Report Describing Three Cases of Challenging or Failed Intubation after Cervical Spine Surgery: A Peril of Early Extubation

Puneet Mishra
1   Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
,
Kelly Louise Mishra
1   Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
,
Cassandra Palmer
1   Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
,
Amy Robertson
1   Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
› Author Affiliations
Further Information

Publication History

02 April 2019

02 September 2019

Publication Date:
13 November 2019 (online)

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Abstract

Postoperative airway complications can be a common, yet perhaps underappreciated, complication in patients undergoing cervical spine surgery. Presented here are three cases in which patients experienced postoperative airway compromise, resulting in difficulty establishing a secure airway following cervical spine operations. Establishing factors that contribute to airway complications after cervical spine surgery can aid in early identification of high-risk patients to create an appropriate airway management strategy. Ultimately, the frequency of airway difficulty after removal of the endotracheal tube in patients undergoing cervical spine surgery should not be taken lightly.

Keywords

cervical spine surgery - reintubation - airway complications

Other Financial Disclosures

P.M. has a research grant funded by St. Jude for an unrelated research project.


K.L.M. has a research grant funded by Baxter for an unrelated research project.


 

  • References

  • 1 Palumbo MA, Aidlen JP, Daniels AH, Thakur NA, Caiati J. Airway compromise due to wound hematoma following anterior cervical spine surgery. Open Orthop J 2012; 6: 108-113
    CrossrefPubMedGoogle Scholar
  • 2 Palumbo MA, Aidlen JP, Daniels AH, Bianco A, Caiati JM. Airway compromise due to laryngopharyngeal edema after anterior cervical spine surgery. J Clin Anesth 2013; 25 (01) 66-72
    CrossrefPubMedGoogle Scholar
  • 3 Hunningher A, Calder I. Cervical spine surgery. Spine Health 2007; 7 (03) 81-84
    PubMedGoogle Scholar
  • 4 Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A. ; Difficult Airway Society Extubation Guidelines Group. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia 2012; 67 (03) 318-340
    CrossrefPubMedGoogle Scholar
  • 5 Kim M, Rhim SC, Roh SW, Jeon SR. Analysis of the risk factors associated with prolonged intubation or reintubation after anterior cervical spine surgery. J Korean Med Sci 2018; 33 (17) e77
    CrossrefPubMedGoogle Scholar
  • 6 Lin H-T, Ting P-C, Chang W-Y, Yang M-W, Chang C-J, Chou AH. Predictive risk index and prognosis of postoperative reintubation after planned extubation during general anesthesia: a single-center retrospective case-controlled study in Taiwan from 2005 to 2009. Acta Anaesthesiol Taiwan 2013; 51 (01) 3-9
    CrossrefPubMedGoogle Scholar
  • 7 Gowardman JR, Huntington D, Whiting J. The effect of extubation failure on outcome in a multidisciplinary Australian intensive care unit. Crit Care Resusc 2006; 8 (04) 328-333
    PubMedGoogle Scholar
  • 8 Stefanutto TB, Gatt S. Cervical decompression and unexpected soft tissue oedema: case report. Anesth Pain Med 2012; 2 (02) 97-100
    CrossrefPubMedGoogle Scholar
  • 9 Debkowska MP, Butterworth JF, Moore JE, Kang S, Appelbaum EN, Zuelzer WA. Acute post-operative airway complications following anterior cervical spine surgery and the role for cricothyrotomy. J Spine Surg 2019; 5 (01) 142-154
    CrossrefPubMedGoogle Scholar
  • 10 Lim S, Kesavabhotla K, Cybulski GR, Dahdaleh NS, Smith ZA. Predictors for airway complications following single- and multilevel anterior cervical discectomy and fusion. Spine 2017; 42 (06) 379-384
    CrossrefPubMedGoogle Scholar
  • 11 Sagi HC, Beutler W, Carroll E, Connolly PJ. Airway complications associated with surgery on the anterior cervical spine. Spine 2002; 27 (09) 949-953
    CrossrefPubMedGoogle Scholar
  • 12 Epstein NE, Hollingsworth R, Nardi D, Singer J. Can airway complications following multilevel anterior cervical surgery be avoided?. J Neurosurg 2001; 94 (2, Suppl): 185-188
    CrossrefPubMedGoogle Scholar
  • 13 Cavallone LF, Vannucci A. Review article: extubation of the difficult airway and extubation failure. Anesth Analg 2013; 116 (02) 368-383
    CrossrefPubMedGoogle Scholar
  • 14 Suk K-S, Kim K-T, Lee S-H, Park S-W. Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixation. Int Orthop 2006; 30 (04) 290-294
    CrossrefPubMedGoogle Scholar
  • 15 De Bast Y, De Backer D, Moraine J-J, Lemaire M, Vandenborght C, Vincent J-L. The cuff leak test to predict failure of tracheal extubation for laryngeal edema. Intensive Care Med 2002; 28 (09) 1267-1272
    CrossrefPubMedGoogle Scholar
  • 16 Nam TW, Lee DH, Shin JK, Goh TS, Lee JS. Effect of intravenous dexamethasone on prevertebral soft tissue swelling after anterior cervical discectomy and fusion. Acta Orthop Belg 2013; 79 (02) 211-215
    PubMedGoogle Scholar
  • 17 Pedram M, Castagnera L, Carat X, Macouillard G, Vital J-M. Pharyngolaryngeal lesions in patients undergoing cervical spine surgery through the anterior approach: contribution of methylprednisolone. Eur Spine J 2003; 12 (01) 84-90
    CrossrefPubMedGoogle Scholar
  • 18 Schroeder J, Salzmann SN, Hughes AP, Beckman JD, Shue J, Girardi FP. Emergent reintubation following elective cervical surgery: a case series. World J Orthop 2017; 8 (06) 465-470
    CrossrefPubMedGoogle Scholar