A Successful Endotracheal Intubation of a Patient with Ankylosing Spondylitis: A Case Report

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disorder that primarily affects the spine and eventually causes its malformation. Surgery is a common treatment for AS patients. Patients with severe AS usually have difficulty with ventilation or intubation. Therefore, airway management should be carefully evaluated, especially in patients with severe cervical deformities. Anesthesiologists must fully and carefully evaluate the airway in these patients. Case Presentation: A 49-year-old woman with AS suffered from a severe spinal deformity that required surgical treatment under general anesthesia. The patient was monitored for vital signs and adequately oxygenated. Lidocaine was used for cricothyroid puncture and throat anesthesia. The feasibility of tracheal intubation was assessed using a visual laryngoscope to expose the glottis under full surface anesthesia. Finally, a #7 enhanced tracheal catheter was successfully inserted after conventional sequential induction. The surgery was successfully completed, and the patient was discharged 10 days after surgery. Conclusions: Anesthesiologists should fully and carefully assess the presence of a difficult airway in patients with AS, whether it is difficult to ventilate or intubate. Adequate preparation plans are essential.