Airtraq - A Rescue Intubation Device in Huge Neonatal Occipital Encephalocoele in Lateral Position

Encephalocoele consists of herniation of Cerebrospinal Fluid (CSF), meninges and brain tissue through a congenital bony defect in the cranium. Anaesthetic challenges associated with a huge occipital encephalocoele include difficult airway, prone positioning and its complications, and accurate assessment of CSF and blood loss. We describe a case of a 5-day male, first child from a non-consanguineous marriage who was admitted with a huge occipital encephalocoele with micrognathia. In view of anticipated difficult intubation, the baby was induced with sevoflurane and intubated in spontaneously breathing with the help of infant size 0 Airtraq optical laryngoscope device in lateral position after one failed intubation attempt with direct laryngoscopy in supine. The intraoperative course remained uneventful. Recovery from anaesthesia was satisfactory and postoperative course was uneventful. After monitoring in the Intensive Care Unit for a day, the patient was shifted to the ward and discharged on the 10^th post-operative day with advice for regular follow up.