[Use of the Pentax-AWS videolaryngoscope and an exchange catheter for tube exchange].

The Pentax-AWS videolaryngoscope (Tokyo, Japan) has been used successfully to intubate the trachea in patients with difficult airways. We report the use of the Pentax-AWS for tube exchange in a patient with difficult airway. In a 57-year-old man scheduled for laminectomy of the cervical spines, tracheal intubation of a reinforced tube was accomplished with a great difficulty. At the end of surgery, the patient had convulsions with irregular breathing. Emergency magnetic resonance imaging of the head and neck was planned, and thus it became necessary to exchange the metallic reinforced tube by a polyvinylchloride tube. The Pentax-AWS (with a polyvinylchloride tube attached) was inserted, while the reinforced tube was still in place. Under the video image, the cuff of the reinforced tube was deflated, and a tube exchanger was introduced through the polyvinylchloride tube into the trachea, alongside the reinforced tube. The reinforced tube was removed, and the new tube was advanced over the exchanger into the trachea. We suggest that the Pentax-AWS is useful for tube exchange, as one can continuously confirm the entire course of exchange and can detect and rectify any possible problems, such as difficulty in advancing an endotracheal tube over the exchanger.