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The Use of Lidocaine Aerosol Inhalation in an Awake Tracheal Intubation in an Ankylosing Spondylitis Patient with Fiber Optic Bronchoscopy: A Case Report

Xi Yuan Jin, Hao Zhang, Qingxiu Wang*

Ankylosing spondylitis is a chronic inflammatory disease, characterized by fibrous or bony ankylosis and deformity of spine. We report the perioperative course of a patient with long standing ankylosing spondylitis with fixed flexion deformity of the cervical spine and restricted mouth opening. She was scheduled for a laparoscopic cholecystectomy surgery and we performed an awake fiber optic nasal intubation after sufficient topic anesthesia by 2% lidocaine aerosol inhalation and other methods. We aim to discuss the importance of adequate anesthesia in endotracheal intubation and other technique in airway management of severe ankylosing spondylitis patients. This can provide several referential experiences in endotracheal intubation in other difficult airways with cervical deformity or other situations unexpected.