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Anesth Analg 2008; 106:260-262
© 2008 International Anesthesia Research Society
doi: 10.1213/01.ane.0000287661.81400.cb
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GENERAL ARTICLES

Subcutaneous Cervical and Facial Emphysema with the Use of the Bonfils Fiberscope and High-Flow Oxygen Insufflation

Thomas M. Hemmerling, MD, DEAA, and David Bracco, MD

From the Department of Anesthesiology, McGill University Health Center, Montreal General Hospital, Montreal, Quebec, Canada.

Address correspondence and reprint requests to Thomas M. Hemmerling, MD, DEAA, Department of Anesthesiology, McGill University, Montreal General Hospital, 1650 Cedar Ave., Montreal H3G 1A4, Canada. Address e-mail to thomashemmerling{at}hotmail.com.

We present a case in which use of the Bonfils retromolar intubation fiberscope resulted in cervical and facial subcutaneous emphysema. The patient was a 75-yr-old woman with Mallampati Grade I airway. The Bonfils retromolar intubation fiberscope was used for teaching purposes. Flow on the oxygen port of the fiberscope was set at 10 L/min. Immediately after insertion of the scope, her whole face and cervical skin showed severe subcutaneous emphysema. The patient was intubated conventionally and the emphysema resolved within 24 h. Subcutaneous emphysema after air insufflation is known from dental procedures with air entering through holes in the teeth. In our case, the oxygen insufflation was sufficient to create emphysema, probably through tiny mucosal lesions.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.