Local airway anaesthesia for awake fibreoptic intubation

Pirlich, Nina; Noppens, Ruediger

doi:10.1016/j.tacc.2016.10.002

Cited by 6 publications

(3 citation statements)

References 48 publications

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“…This seems notable given that successful outcome of an awake intubation is considered a net result of different factors including appropriate case selection and good patient preparation to optimize the patient's comfort and compliance as well as technical expertise method of intubation [24]. …”

Section: Discussionmentioning

confidence: 99%

Use of Awake Flexible Fiberoptic Bronchoscopic Nasal Intubation in Secure Airway Management for Reconstructive Surgery in a Pediatric Patient with Burn Contracture of the Neck

Totoz

Müslümanoğlu²,

Taskin³

et al. 2018

Case Reports in Anesthesiology

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Although the use of awake flexible fiberoptic bronchoscopic (FFB) intubation is a well-recognized airway management technique in patients with difficult airway, its use in smaller children with burn contractures or in an uncooperative older child may be challenging. Herein, we report successful management of difficult airway in a 7-year-old boy with burn contracture of the neck, by application of FFB nasal intubation in a stepwise approach, first during an initial preoperative trial phase to increase patient cooperation and then during anesthesia induction for the reconstructive surgery planned for burn scars and contractures. Our findings emphasize the importance of a preplanned algorithm for airway control in secure airway management and feasibility of awake FFB intubation in a pediatric patient with burn contracture of the neck during anesthesia induction for reconstructive surgery. Application of FFB intubation based on a stepwise approach including a trial phase prior to operation day seemed to increase the chance of a successful intubation in our patient in terms of technical expertise and increased patient cooperation and tolerance by enabling familiarity with the procedure.

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Section: Discussionmentioning

confidence: 99%

Use of Awake Flexible Fiberoptic Bronchoscopic Nasal Intubation in Secure Airway Management for Reconstructive Surgery in a Pediatric Patient with Burn Contracture of the Neck

Totoz

Müslümanoğlu²,

Taskin³

et al. 2018

Case Reports in Anesthesiology

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“…The spray-asyou-go technique using fiberoptic bronchoscope provides flexibility in selectively anaesthetizing respiratory passages. [10] This may be related to the fact that local anaesthetic injected by working channel of fiberscope or epidural catheter or angiographic catheter placed in working channel cannot be reduced to extremely fine cloud. Fine Section: Anaesthesia spray can be achieved by addition of air or oxygen.…”

Section: Introductionmentioning

confidence: 99%

Awake Fiberoptic Intubation: Comparison Of Three Techniques of Spray-As-You-Go

Shobha¹,

Bhatia²,

Chamoli³

et al. 2018

AIMDR

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“…It is important to optimize patient`s comfort during awake intubation, which increase patient`s compliance and maximize the chance of successful intubation in spontaneous breathing patient [1]. Despite providing comfort with local airway anesthesia, patient with closed mouth is always challenging for anesthesiologist.…”

Section: Introductionmentioning

confidence: 99%

Difficult Airway in a Patient with Jaw Fracture: A Case Report

2017

JAPM

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Introduction Major trauma cases with jaw fracture are a significant airway management challenge for anesthesiologist. Awake intubation while preserving spontaneous ventilation is a very stressful situation, especially cases with preexisting psychosis. Presentation of the Case This motor vehicle collation case was unable to open mouth due to fractures and dislocation of jaw. Case was positive for personal history of psychosis. Anesthetic plan was to incubate nasally. Due to agitation, it appears to be difficult to perform an awake nasal incubation and to anesthetize the upper airway. Decision was made to perform awake oral intubation nerve blocks to obtund the gag reflex; and three major nerves which supply airway were blocked. The tube was advanced slowly until it was certain that the tube was successfully placed in the trachea as the sound of the whistle became louder. Conclusion The use of whistle to localize trachea is a lost art. An old trick of intubation which is being lost by technological devices could still work in a skill full hand.

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Local airway anaesthesia for awake fibreoptic intubation

Cited by 6 publications

References 48 publications

Use of Awake Flexible Fiberoptic Bronchoscopic Nasal Intubation in Secure Airway Management for Reconstructive Surgery in a Pediatric Patient with Burn Contracture of the Neck

Use of Awake Flexible Fiberoptic Bronchoscopic Nasal Intubation in Secure Airway Management for Reconstructive Surgery in a Pediatric Patient with Burn Contracture of the Neck

Awake Fiberoptic Intubation: Comparison Of Three Techniques of Spray-As-You-Go

Difficult Airway in a Patient with Jaw Fracture: A Case Report

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