Airway management in prone position: a case of knife injury in the posterior spine

Airway management in prone position is a very challenging procedure, predicting a difficult airway situation. We present a case of an adult with knife injury in the posterior spine, needing surgical care. Because of possible dislodgment of the knife with life-threatening complications, supine and lateral decubitus positions were not considered for airway management. To get around this difficulty, we used a fiberoptic intubation through supraglottic device I-gel® in prone position, under general anesthesia, to secure the airway. This case shows the use of fiberoptic intubation through an I-gel® supraglottic device, in prone position, as a valid choice.