AN UNEXPECTED IMPROVEMENT IN CORMACK LEHANE GRADE BY USE OF STYLET IN A CASE OF DIFFICULT AIRWAY

Shweta Jain, Saurav Agarwal*, Megha Arora, Vikram Bedi, Hemraj Tungria and Snigdha Singh

ABSTRACT

Failed intubation is always a major concern for anaesthesiologist because of devastating outcomes associated with it. Here we present a case of 50 year old patient posted for perforation peritonitis. On airway assessment patient had inter incisor gap of 3 finger breadth, adequate neck flexion and extension and Mallampatti class III. We describe how we emergently secured the airway with endotracheal tube (ETT) of size 8mm internal diameter after introducing a stylet blindly into the trachea and on removing suddenly Cormack and Lehane laryngoscopic view changed from grade III to I without any external manipulation. This incidental finding may be very useful in anticipated and unanticipated difficult airway scenarios. The essence of this case report is about the preparation for facing unanticipated difficult airway and measures to tackle them when we face them.

Keywords: Difficult airway, Endotracheal tube, Stylet.