Awake fiberoptic nasotracheal intubation for patients with difficult airway
10.17245/jdapm.2018.18.5.301
- Author:
Masanori TSUKAMOTO
1
;
Takashi HITOSUGI
;
Takeshi YOKOYAMA
Author Information
1. Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan. tsukamoto@dent.kyushu-u.ac.jp
- Publication Type:Case Report
- Keywords:
Conscious Sedation;
Fiberoptic Nasotracheal Intubation;
Topical Anesthesia
- MeSH:
Airway Obstruction;
Anesthesia;
Conscious Sedation;
Epiglottis;
Fentanyl;
Humans;
Intubation;
Male;
Masks;
Methods;
Midazolam;
Nasal Cavity;
Oxygen;
Respiration;
Surgery, Oral;
Trachea;
Vocal Cords
- From:Journal of Dental Anesthesia and Pain Medicine
2018;18(5):301-304
- CountryRepublic of Korea
- Language:English
-
Abstract:
Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received 50 µg of fentanyl 2–3 times (total 2.2–2.3 µg/kg) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1–4 times (total 0.02–0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.
