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Med J Armed Forces India. 2005 Jan;61(1):22-5. doi: 10.1016/S0377-1237(05)80112-1. Epub 2011 Jul 21.

Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques.

Author information

1
Classified Specialist (Anaesthesia and Paediatric Anaesthesia), Army Hospital (R & R), Delhi Cantt.
2
Ex-Professor & Head, Department of Anaesthesiology & Critical care, Armed Forces Medical College, Pune-40.
3
Commandant, Armed Forces Medical Store Depot, Lucknow.
4
Graded Specialist (Anaesthesia), 7 Air Force Hospital, Kanpur.

Abstract

BACKGROUND:

The successful conduct of fiberoptic aided intubation is dependent upon effective local anaesthesia. The aim of the study was to compare three different methods of anaesthetizing the airway.

METHODS:

60 adult patients (American Society of Anaesthesiologists status I-III and Mallampati class III & IV), scheduled for elective surgery, received sedation followed by spraying of the nares and posterior pharyngeal wall with 4% lignocaine. Thereafter the patients received 4 ml of 4% lignocaine either by transtracheal injection (n=20, group A), via intubating fiberscope (Pentax F1-10P2) using 'spray as you go' technique (n=20, group B) or by nebulizer (Devilbiss 5610W) 20 min before intubation, (n=20, group C). Patients were asked to score the procedure using visual analog scale (VAS) and severity scores. Episodes of coughing, choking, stridor, extra / total local anaesthetic used and intubation times were recorded. Patients were monitored continuously for vital parameters.

RESULTS:

Group B patients showed better VAS scores with shorter intubation times and had a lower incidence of coughing and choking. The endoscopists' VAS scores also showed a preference for group B.

CONCLUSION:

In conclusion the 'spray as you go' technique was safe, provided effective local anaesthesia and was preferred by both patients and endoscopists.

KEYWORDS:

Awake intubation; Difficult airway; Fiberoptic intubation

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