Airway management after cervical spine surgery

· Problems: oedema + immobility

· Risks: difficult intubation + failed extubation

· Beware the delayed airway disaster

More swelling

· A+P approach

· Multiple levels

· Long duration (>5 hours)

· Lots of bleeding (>300mL)

More consequential

· High vertebral level (above C4)

· Stiff spine

· Myelopathy

· OSA

· Lung disease

· Stridor

· Distress

· Dyspnoea

· Dysphonia

· Dysphagia

· Swollen face

Intubation

· Video laryngoscopy

· Awake intubation

Extubation

· Cuff leak test

· ICU observation

· Extubate tomorrow