Awake tracheal intubation using Pentax airway scope in 30 patients: A Case series

Abstract

Background and Aims:Pentax airway scope (AWS) has been successfully used for managing difficult intubations. In this case series, we aimed to evaluate the success rate and time taken to complete intubation, when AWS was used for awake tracheal intubation.Methods:We prospectively evaluated the use of AWS for awake tracheal intubation in 30 patients. Indication for awake intubation, intubation time, total time to complete tracheal intubation, laryngoscopic view (Cormack and Lehane grade), total dose of local anaesthetic used, anaesthetists rating and patient's tolerance of the procedure were recorded.Results:The procedure was successful in 25 out of the 30 patients (83%). The mean (standard deviation) intubation time and total time to complete the tracheal intubation was 5.4 (2.4) and 13.9 (3.7) min, respectively in successful cases. The laryngeal view was grade 1 in 24 and grade 2 in one of 25 successful intubations. In three out of the five patients where the AWS failed, awake tracheal intubation was successfully completed with the assistance of flexible fibre optic scope (FOS).Conclusion:Awake tracheal intubation using AWS was successful in 83% of patients. Success rate can be further improved using a combination of AWS and FOS. Anaesthesiologists who do not routinely use FOS may find AWS easier to use for awake tracheal intubation using an oral route.

Failed fibreoptic intubation: 70° rigid nasendoscope and Frova introducer to the rescue

“…[ 5 ] Videolaryngoscopy in awake patients with obstructed airway requires liberal use of local anaesthetics, and patient co-operation is mandatory. [ 6 ] In addition, use of local anaesthesia can itself induce airway collapse resulting in complete airway obstruction even before an attempt is made to guide the endotracheal tube across the laryngeal mass.…”

Awake tracheal intubation with C-MAC® video laryngoscope in a patient with corrosive injury-induced pharyngeal stricture

“…A similar technique for glottic topicalisation using a 8 FG suction catheter passed through the preloaded ETT on the Pentax AWS ® has also been reported. [ 2 ] The MADgic ® atomizer is another device which has been used successfully to deliver atomized local anaesthetic for topicalization of the laryngotracheal region. [ 3 ] In the absence of a fibreoptic scope, C-MAC ® videolaryngoscope and the above-mentioned topicalization method can be safely used as an alternative option for awake tracheal intubation.…”

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