Should we reconsider awake neonatal intubation? A review of the evidence and treatment strategies

Duncan, Heather; Zurick, Natasha J.; Wolf, Andrew

doi:10.1046/j.1460-9592.2001.00535.x

Cited by 68 publications

(41 citation statements)

References 104 publications

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“…Numerous combinations of analgesics, amnesics [4,12] and airway topical anaesthesia have been used for awake nasotracheal intubation. The primary aim of this study was to determine differences in the efficacy of airway topical anaesthesia between 2 % lignocaine nebulisation and 2 % lignocaine via spray-as-you-go technique for AFOI.…”

Section: Discussionmentioning

confidence: 99%

Nebulisation Versus Spray-as-You-Go Airway Topical Anaesthesia in Patients with Temporomandibular Joint Ankylosis using 2 % Lignocaine

Dhasmana

Singh

Pal

2014

J. Maxillofac. Oral Surg.

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Study Design This randomized, comparative clinical study was designed to compare 2 % lignocaine nebulization and 2 % lignocaine via spray-as-you-go technique for topical airway anaesthesia during or awake flexible fiberoptic intubation (AFOI) in temporomandibular joint (TMJ) ankylosis patients. Methods Sixty adult patients with TMJ ankylosis were randomly assigned to the following study groups using a computer generated random number table 2 % lignocaine nebulised (group A) and 2 % lignocaine via spray-as-yougo technique (group B). After airway anaesthesia, awake flexible fiberoptic nasotracheal intubation was performed. An independent investigator who did not participate in the study scored patients' comfort during airway topical anaesthesia and patients' reaction during awake FOI. Changes in haemodynamics during the airway manipulation were also observed. Results There were no statistically significant differences in the observed variables between the two groups. Conclusions Both 2 % lignocaine nebulization and 2 % lignocaine spray-as-you-go technique provided acceptable conditions for AFOI in TMJ patients.

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Section: Discussionmentioning

confidence: 99%

Nebulisation Versus Spray-as-You-Go Airway Topical Anaesthesia in Patients with Temporomandibular Joint Ankylosis using 2 % Lignocaine

Dhasmana

Singh

Pal

2014

J. Maxillofac. Oral Surg.

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“…Numerous combinations of analgesics and amnesics have been used for awake blind nasotracheal intubation [14]. Fentanyl and alfentanil with diazepam, as well as fentanyl with propofol [15][16][17] have been studied for the purpose.…”

Section: Discussionmentioning

confidence: 99%

Awake Blind Nasotracheal Intubation in Temporomandibular Joint Ankylosis Patients under Conscious Sedation Using Fentanyl and Midazolam

Dhasmana

Singh

Pal

2010

J. Maxillofac. Oral Surg.

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“…Three recent review articles summarize the outcomes of various premedication regimens for nonemergent intubation. [23][24][25] In addition to improving chances for successful intubation, paralytic agents are reported to attenuate adverse physiologic changes experienced during intubation attempts. Increased intracranial pressure, 2,3,26,27 increased systolic blood pressure 28 and longer duration of hypoxemia 10,29 have been reported in awake vs paralyzed neonatal intubations.…”

Section: Common Practicesmentioning

confidence: 99%

Rocuronium for nonemergent intubation of term and preterm infants

et al. 2010

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Objective: The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.Study Design: Preterm infants requiring nonemergent intubation were randomized to receive atropine and fentanyl with or without rocuronium. Outcomes, patient characteristics and intubator's experience were noted. Onset, duration and degree of clinical paralysis were recorded for rocuronium group and for older infants receiving rocuronium per unit protocol.Result: Forty-four intubations were randomized (20 rocuronium, 24 control). Groups were similar in chronological and corrected gestational age, weight and intubator's experience. Successful intubation on first attempt was achieved in 35% of intubations under rocuronium vs 8% of controls; rocuronium was the only significant variable by logistic regression (odds ratio ¼ 0.052, P ¼ 0.029). Complete paralysis was reported in 80% of 57 rocuronium intubations; onset ranged from 14 to 178 s (65.9±43.4), and duration from 1 to 60 min (16.3 ± 13.5).Conclusion: Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.

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Should we reconsider awake neonatal intubation? A review of the evidence and treatment strategies

Cited by 68 publications

References 104 publications

Nebulisation Versus Spray-as-You-Go Airway Topical Anaesthesia in Patients with Temporomandibular Joint Ankylosis using 2 % Lignocaine

Nebulisation Versus Spray-as-You-Go Airway Topical Anaesthesia in Patients with Temporomandibular Joint Ankylosis using 2 % Lignocaine

Awake Blind Nasotracheal Intubation in Temporomandibular Joint Ankylosis Patients under Conscious Sedation Using Fentanyl and Midazolam

Rocuronium for nonemergent intubation of term and preterm infants

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