The use of an i-gel supraglottic airway for the airway management of a patient with subglottic stenosis: a case report.

Abstract

The airway management of patients with subglottic stenosis poses many challenges for the anesthesiologist. Although many anesthesiologists would prefer the use of a narrow endotracheal tube in this patient population, the use of laryngeal mask airways has also been described. We report the case of a patient who was managed using an i-gel supraglottic airway due to a difficulty with inserting an endotracheal tube during a previous procedure. A 47-year old woman with an ASA (American Society of Anesthesiologists) score of I was scheduled to undergo a laparoscopic cholecystectomy. An i-gel supraglottic airway was inserted without difficulty, provided a good seal, and allowed for controlled ventilation with acceptable peak pressures throughout the operation, including during pneumoperitoneum. Furthermore, the vocal cords were successfully visualized using a fiberscope, allowing the possibility of eventual fiberoptic intubation, if it had been necessary. The presence of subglottic stenosis was also confirmed using the fiberscope. Thus, the i-gel airway device has multiple features that makes it suitable for use in situations where a narrow endotracheal tube is inadvisable or too difficult to use.