Retrospective evaluation of airway management of patients operated due to cervical pathology in hacettepe university Hacettepe üniversitesi nöroşirurki ameliyathanelerinde servikal patoloki nedeniyle ameliyat olan hastalarda havayolu yönetiiminin retrospektif deǧerlendirilmesi neurosurgical operating rooms

Özkaragöz D. B., UZUN Ş., Üzümcügil F., AYPAR Ü.

Anestezi Dergisi, vol.25, no.2, pp.70-76, 2017 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 2
  • Publication Date: 2017
  • Journal Name: Anestezi Dergisi
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.70-76
  • Keywords: Airway management, Cervical instability, Cervical surgery
  • Lokman Hekim University Affiliated: Yes


Aim: Cervical spinal injury is seen as 15-3% of all traumas and is a major cause of morbidity and mortality (1). In these patients, inappropriate management of airways can cause serious neurological damage. Neurological damage can be caused by mechanical movements at the level of cervical instability, or hypoventilation and hypoxia due to misuse of airway devices. The aim of this study is to investigate the airway management in patients who undergo cervical surgery in our hospital. Method: After ethical committee approval, the files of the patients who had cervical surgery by the neurosurgery department of Hacettepe University between the dates of 1 January 2003-31 December 2013 were examined retrospectively. Datas including the patients' age, gender, body mass, comorbidities, ASA scores, Mallampati scores, difficult airway history, preoperative and postoperative neurologic examinations, mask ventilation, type of cervical pathology, muscle relaxant used in induction, position of the surgery, and complications were collected from their charts. Results: Fiberoptic intubation was performed in patients who were operated on due to cervical trauma and dislocation. In the patients who had not documented cervical trauma and dislocation, the proportions of laryngoscopy and videolaryngoscopy use were the same. There was no significant difference between the types of muscle relaxant used and intubation methods. In all the patients, preoperative and postoperative neurological examinations were compared. In total, 5 patients developed postoperative neurologic deterioration but there was no relation to the airway devices used. Conclusion: Based on this data, we concluded that the airway management must be both safe enough to protect cervical stability and fast enough not to cause hypoxia. If there is any doubt of cervical instability, fiberoptic intubation (awake or under anaesthesia) must be preferred. If there is not enough experience, videolaryngoscopy can also be used.