Korean J Anesthesiol.  1990 Oct;23(5):807-810. 10.4097/kjae.1990.23.5.807.

Retrograde Endotracheal Intubation Using a Guide Wire in a Pediatric Patient

• Lee KD
• Suh JH
• Kim SN

• KMID: 2240717
• DOI: http://doi.org/10.4097/kjae.1990.23.5.807

Abstract

An 8-year-old male with ankylosis of both temporomandibular joints was scheduled for an elective condylectomy. Physical examination revealed a relatively healthy appearing child, weighing 25 kg, with 5-7mm of maximal oral opening. The EKG, chest x-ray and laboratory data were within normal limits. An attempt at local infiltration after injection of droperidol 2.5 mg for retrograde technique was unsuccessful. Subsequently, anesthesia was induced with thiopental, halothane, nitrous oxide and oxygen via a mask. The cricothyroid membrane was punctured with an 18 gauge Touhy needle. After confirmation of the intratracheal position by aspiration of air into a fluid filled syringe, a flexible guide wire tip of CVP catheter (VYGON) was threaded via this needle superiorly into the posterior pharynx through the larynx. After introduction of the guide wire into right naris, the nasotracheal tube was threaded over the wire, and the tip of the tube in the trachea at the site of the cricothyroid membrane puncture was confirmed by palpation and visual inspection. The nasotracheal tube was advaned further into the trachea after removal of the guide wire. Auscultation confirmed appropriate intratracheal placement.

Keyword

Retrograde intubation; Guide wire; Pediatric

MeSH Terms

Anesthesia
Ankylosis
Auscultation
Catheters
Child
Droperidol
Electrocardiography
Halothane
Humans
Intubation, Intratracheal*
Larynx
Male
Masks
Membranes
Needles
Nitrous Oxide
Oxygen
Palpation
Pharynx
Physical Examination
Punctures
Syringes
Temporomandibular Joint
Thiopental
Thorax
Trachea
Droperidol
Halothane
Nitrous Oxide
Oxygen
Thiopental