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Awake light-aided blind nasal intubation: prototype device
Faculty
Medicine
Year:
2010
Type of Publication:
Article
Pages:
254-259
Authors:
Nofal, O
DOI:
10.1093/bja/aep367
Journal:
BRITISH JOURNAL OF ANAESTHESIA OXFORD UNIV PRESS
Volume:
104
Research Area:
Anesthesiology
ISSN
ISI:000273867400018
Keywords :
airways, anticipated difficult, mouth opening, locked jaw, device, light-aided intubating catheter, intubation, awake, blind nasal, transillumination, fibreoptic
Abstract:
Limited mouth opening associated with unavailable or ineffective fibreoptic bronchoscope (FOB) is an intubation challenge. A light-aiding device may facilitate the blind nasal intubation. Awake blind nasal intubation was planned for 16 elective patients with inaccessible oral route (three children and 13 adults, ASA I-II). Topical anaesthesia for the supraglottis, glottis, and upper trachea was performed using prototype supraglottic topical anaesthesia device and cricothyroid injection of local anaesthesia. Hand-made light-aiding intubation device was used to help blind nasal intubation. Three attempts of blind nasal intubation (60 s each) were allowed, otherwise failure and FOB intubation were considered. During the procedure, heart rate, mean arterial pressure, and arterial oxygen saturation (Spa(o2)) were measured. Temperature created at the bulb surface of the device was measured for 4 min duration, with and without exposing the bulb to oxygen flow of 6 litre min(-1). All the patients were successfully intubated except one child. Time to intubate in adults was mean (sd) 52.7 (8.6) s. Spa(o2) showed significant difference between before and after procedural values. The maximum temperature recorded at the bulb surface was 46.8 (0.4)degrees C and 48.1 (0.8)degrees C with and without oxygen flow, respectively. The device appeared to be a safe and cost-effective transillumination method for blind nasal intubation in difficult airways.
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جامعة المنصورة
جامعة الاسكندرية
جامعة القاهرة
جامعة سوهاج
جامعة الفيوم
جامعة بنها
جامعة دمياط
جامعة بورسعيد
جامعة حلوان
جامعة السويس
شراقوة
جامعة المنيا
جامعة دمنهور
جامعة المنوفية
جامعة أسوان
جامعة جنوب الوادى
جامعة قناة السويس
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