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British Journal of Anaesthesia, 2002, Vol. 88, No. 5 728-732
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Rigid nasendoscope with video camera system for intubation in infants with Pierre-Robin sequence

M. Ravishankar1, P. Kundra*,1, K. Agrawal2, N. S. Kutralam1, N. Arun and O. P. Vijaykumar1

1Department of Anaesthesiology and Critical Care and 2Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605 006, India*Corresponding author: D-II/21, JIPMER campus, Pondicherry 605 006, India

We describe an alternative intubation technique using a rigid nasendoscope and a video camera monitor system in two infants with Pierre-Robin sequence presenting for palatoplasty. After induction with an inhalational anaesthetic technique, the tracheas of the infants could not be intubated with direct laryngoscopy using a Wisconsin blade. In the absence of a flexible paediatric fibrescope, a rigid endoscope (2.7 mm, 70° lateral illumination) was passed orally to provide a view of the glottis on the monitor screen. A tracheal tube, bent into a J-shape using a stylet, was inserted orally and manipulated into the trachea, under video guidance. This technique proved to be simple, permitting a favourable view of the glottis. It should be considered for passing a tracheal tube through the vocal cords in infants who present with a difficult airway.

Br J Anaesth 2002; 88: 728–31.


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