Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation
Background and Aims: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. Methods: It was a prospective, randomised controlled study of 33 pat...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=661;epage=666;aulast=Vasu |
| _version_ | 1818192498514722816 |
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| author | Bindu K Vasu Sunil Rajan Jerry Paul Lakshmi Kumar |
| author_facet | Bindu K Vasu Sunil Rajan Jerry Paul Lakshmi Kumar |
| author_sort | Bindu K Vasu |
| collection | DOAJ |
| description | Background and Aims: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. Methods: It was a prospective, randomised controlled study of 33 patients with the American Society of Anesthesiologists' physical status 1–3 with anticipated difficult airway requiring AFOI. The primary objective was to compare the patient comfort after topical anaesthesia of the airway using atomiser with transtracheal injection of the local anaesthetic agent for AFOI in patients with anticipated difficult airway. The secondary objectives were to compare the ease of intubation, time required to intubate and the haemodynamic changes during intubation. After topical anaesthesia of nostrils, patients in Group T received transtracheal injection of 4 ml of 4% lignocaine whereas Group A patients received 4-5mL of 4% atomised lignocaine using DeVilbiss atomiser before AFOI. Patient comfort assessed objectively by the anaesthetic assistant during the procedure, ease of intubation assessed using cough and gag reflex score, time taken to intubate and the haemodynamic changes during the procedure were compared. Results: Ease of intubation, patient comfort and the time taken to intubate were significantly better in Group T patients, with P = 0.001, 0.009 and 0.019, respectively, compared with the patients in Group A. There were no significant changes in haemodynamic parameters. Conclusion: Topical anaesthesia by transtracheal injection in patients with anticipated difficult airway made AFOI easier and faster with better patient comfort compared to atomiser with no clinically significant untoward side effects. |
| first_indexed | 2024-12-12T00:31:28Z |
| format | Article |
| id | doaj.art-94bc93bf76dd4404956bc61ecac2b83b |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-12T00:31:28Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-94bc93bf76dd4404956bc61ecac2b83b2022-12-22T00:44:29ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172017-01-0161866166610.4103/ija.IJA_249_17Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubationBindu K VasuSunil RajanJerry PaulLakshmi KumarBackground and Aims: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. Methods: It was a prospective, randomised controlled study of 33 patients with the American Society of Anesthesiologists' physical status 1–3 with anticipated difficult airway requiring AFOI. The primary objective was to compare the patient comfort after topical anaesthesia of the airway using atomiser with transtracheal injection of the local anaesthetic agent for AFOI in patients with anticipated difficult airway. The secondary objectives were to compare the ease of intubation, time required to intubate and the haemodynamic changes during intubation. After topical anaesthesia of nostrils, patients in Group T received transtracheal injection of 4 ml of 4% lignocaine whereas Group A patients received 4-5mL of 4% atomised lignocaine using DeVilbiss atomiser before AFOI. Patient comfort assessed objectively by the anaesthetic assistant during the procedure, ease of intubation assessed using cough and gag reflex score, time taken to intubate and the haemodynamic changes during the procedure were compared. Results: Ease of intubation, patient comfort and the time taken to intubate were significantly better in Group T patients, with P = 0.001, 0.009 and 0.019, respectively, compared with the patients in Group A. There were no significant changes in haemodynamic parameters. Conclusion: Topical anaesthesia by transtracheal injection in patients with anticipated difficult airway made AFOI easier and faster with better patient comfort compared to atomiser with no clinically significant untoward side effects.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=661;epage=666;aulast=VasuAtomisationawake fibreoptic intubationlocal anaestheticpatient comforttranstracheal |
| spellingShingle | Bindu K Vasu Sunil Rajan Jerry Paul Lakshmi Kumar Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation Indian Journal of Anaesthesia Atomisation awake fibreoptic intubation local anaesthetic patient comfort transtracheal |
| title | Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| title_full | Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| title_fullStr | Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| title_full_unstemmed | Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| title_short | Efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| title_sort | efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for awake fibreoptic intubation |
| topic | Atomisation awake fibreoptic intubation local anaesthetic patient comfort transtracheal |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=8;spage=661;epage=666;aulast=Vasu |
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