The New Maneuver for Difficult Intubation

It is believed that the airway management is more difficult in obese than nonobese patients due to the anatomic changes resulting from overweight. In this investigation was studied the new maneuver for difficult tracheal intubation in one obese patient. An 85 year old obese and diabetic man with cardiopulmonary arrest and without history of trauma was brought to the emergency department (ED). In this patient, the neck circumference was greater and sternomental distance was shorter than ordinary individuals. The cardiopulmonary resuscitation (CPR) was begun for patient immediately. In this patient, tracheal intubation with the conventional method was unsuccessful. Then, the new method (swan neck maneuver) for difficult intubation was attempted in patient successfully. In this maneuver, the upper part of the back of patient was elevated with bolsters so that the neck of patient was extended at ease and pharyngeal axis was perch along with laryngeal axis. Then, intubation was performed in this position simply. It looks that this new maneuver can perform easily for difficult intubations in obese patients without history of trauma.