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Awake nasotracheal intubation with a 300-mm working length fiberscope: a prospective observational feasibility trial
Marchis, Ioan Florin; Zdrehus, Claudiu; Pop, Sever; Radeanu, Doinel; Cosgarea, Marcel; Mitre, Calin Iosif.
Afiliação
  • Marchis, Ioan Florin; University of Medicine and Pharmacy Iuliu Hatieganu. Anaesthesia and Intensive Care Department. Cluj- Napoca. RO
  • Zdrehus, Claudiu; University of Medicine and Pharmacy Iuliu Hatieganu. Anaesthesia and Intensive Care Department. Cluj- Napoca. RO
  • Pop, Sever; University of Medicine and Pharmacy Iuliu Hatieganu. Otorhinolaryngology Department. Cluj- Napoca. RO
  • Radeanu, Doinel; University of Medicine and Pharmacy Iuliu Hatieganu. Otorhinolaryngology Department. Cluj- Napoca. RO
  • Cosgarea, Marcel; University of Medicine and Pharmacy Iuliu Hatieganu. Otorhinolaryngology Department. Cluj- Napoca. RO
  • Mitre, Calin Iosif; University of Medicine and Pharmacy Iuliu Hatieganu. Anaesthesia and Intensive Care Department. Cluj- Napoca. RO
Braz. J. Anesth. (Impr.) ; 73(5): 556-562, 2023. tab, graf
Article em En | LILACS | ID: biblio-1520354
Biblioteca responsável: BR891.2
ABSTRACT
Abstract

Background:

Awake fiberoptic tracheal intubation is an established method of securing difficult airways, but there are some reservations about its use because many practitioners find it technically complicated, time-consuming, and unpleasant for patients. Our main goal was to test the safety and efficacy of a 300-mm working length fiberscope (video rhino-laryngoscope) when used for awake nasotracheal intubation in difficult airway cases.

Methods:

This was a prospective, single-center study involving adult patients, having an ASA physical status between I and IV, with laryngopharyngeal pathology causing distorted airway anatomy. Awake nasotracheal intubation, using topical anesthesia and light sedation, was performed using a 300 mm long and 2.9 mm diameter fiberscope equipped with a lubricated reinforced endotracheal tube. The primary outcomes were the success and duration of the procedure. Patients' periprocedural satisfaction and other incidents were recorded.

Results:

We successfully intubated all 25 patients included in this study. The mean ± SD duration of the procedure, starting from the passage of the intubating tube through one of the nostrils until the endotracheal intubation, was 76 ± 36 seconds. Most of the patients showed no discomfort during the procedure with statistical significance between the No reaction Group with the Slight grimacing Group (95%CI 0.13, 0.53, p = 0.047) and the Heavy grimacing Group (95%CI 0.05, 0.83, p = 0.003). The mean ±SD satisfaction score 24 hours post-intervention was 1.8 ± 0.86 - mild discomfort. No significant incidents occurred.

Conclusions:

Our study showed that a 300-mm working length flexible endoscope is fast, safe, and well-tolerated for nasotracheal awake intubation under challenging airways.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Endoscopia / Manuseio das Vias Aéreas Idioma: En Revista: Braz. J. Anesth. (Impr.) Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Romênia País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Endoscopia / Manuseio das Vias Aéreas Idioma: En Revista: Braz. J. Anesth. (Impr.) Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Romênia País de publicação: Brasil