Management of difficult airways in anesthesia: experience report

Abstract

Introduction: The difficult airway (DAV) is a significant challenge in anesthesiology and can lead to serious complications such as hypoxia and death. Effective management of DAV requires a multidisciplinary approach and the use of specialized equipment, as well as clear protocols. Aim: to describe the results of implementing a safety protocol for anesthetic procedures in patients with VAD in the Surgical Centre of a university hospital. Methods: Experience report. The Plan-Do-Check-Act (PDCA) cycle was used as a tool to implement the VAD management protocol. VAD indicators were analyzed between November 2023 and August 2024, the period after the team was trained and the protocol was implemented. Data was collected from administrative and operational records. Results: In total, 100 patients with VAD were identified in 6,283 surgeries (1.59%), the majority of whom were male (61%) with a mean age of 49.23 years. Around 68 per cent of patients were classified as ASA III and 86 per cent had Mallampati grades 3 and 4, reflecting greater difficulty in intubation. The specialities with the highest prevalence of VAD were neurosurgery (13%), head and neck surgery (12%) and urology (10%), with 79% of elective surgeries. The videolaryngoscope was the most commonly used device (50 per cent) and 10 per cent of cases had complications. Conclusions: The implementation of the protocol based on the PDCA cycle showed positive results, reinforcing the need for structured protocols and collaboration between health professionals. Future research should explore the long-term effectiveness of this approach.