Awake fiberoptic intubation (AFOI) is mandatory to manage difficult airways. Superior laryngeal nerve block (SLNB) could reduce risks and improve patient comfort. The aim of this study is to assess the procedural comfort of SLNB during AFOI in a population of patients undergoing upper airway oncological surgery. Forty patients were randomized into two groups and were treated with continuous infusion of remifentanil, topic anesthesia and intercricoid block. In the study group (=20), SLNB was performed with lidocaine (L-SLNB); in the control group (n=20) SLNB was performed using saline (S-SLNB). AFOI was more comfortable in the L-SLNB group compared to S-SLNB patients [FOICS ≤ 1 in 18 patients (90%) L-SLNB; 2 (10%) S-SLNB (P <0.001)]. Intubation was faster in L-SLNB (47.45 ±15.38 sec) than S-SLNB (80.15 ±37.91 sec) (p <0.001). The SLNB procedure during AFOI is a safe and comfortable procedure in a population of patients undergoing upper airways surgery. Time to intubation was shorter in L-SLNB than in S-SLNB.

Download full-text PDF

Source
http://dx.doi.org/10.7417/CT.2020.2236DOI Listing

Publication Analysis

Top Keywords

awake fiberoptic
8
fiberoptic intubation
8
laryngeal nerve
8
nerve block
8
slnb performed
8
patients
5
intubation patients
4
patients stenosis
4
stenosis upper
4
upper airways
4

Similar Publications

Successful awake intubation using Airtraq in a low-resource setting for a patient with severe post-burn contractures.

BMC Anesthesiol

January 2025

Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, 1205, Switzerland.

Background: In resource-limited settings, advanced airway management tools like fiberoptic bronchoscopes are often unavailable, creating challenges for managing difficult airways. We present the case of a 25-year-old male with post-burn contractures of the face, neck, and thorax in Nigeria, who had been repeatedly denied surgery due to the high risk of airway management complications. This case highlights how an awake intubation was safely performed using an Airtraq laryngoscope, the only device available, as fiberoptic intubation was not an option.

View Article and Find Full Text PDF

Arteriovenous malformations (AVMs) in the head and neck present significant challenges due to airway management complexities and hemorrhage risks. This case report describes a 15-year-old female with a congenital facial AVM causing dyspnea and obstructive symptoms. The patient required angioembolization of the AVM, but many hospitals deferred the procedure due to the anticipated difficult airway and severe bleeding risks.

View Article and Find Full Text PDF

Mitigating Aspiration Risk With Awake Intubation: A Case of Intrathoracic Stomach.

Cureus

November 2024

Anesthesiology, Unidade Local de Saúde de Coimbra, Coimbra, PRT.

Hiatal hernias are common in the elderly and in most cases asymptomatic and no intervention is needed. Hiatal hernias can range from asymptomatic to an intrathoracic stomach, a rare but potentially life-threatening condition, characterized by the migration of the stomach into the thoracic cavity. Its need for urgent intervention presents a major concern for the anesthesiologist because it is associated with a high risk of aspiration.

View Article and Find Full Text PDF
Article Synopsis
  • Cervical spine surgery in myelopathy patients presents anesthetic challenges due to the potential for secondary spinal cord injury (SCI), which requires careful management beyond just intubation concerns.
  • Intraoperative neurophysiological monitoring, such as SSEPs and MEPs, is crucial for assessing spinal cord integrity during surgery, especially for patients with conditions like cervical spondylotic myelopathy.
  • A case study involving a 73-year-old male with significant cervical deformation underwent successful anterior cervical discectomy and fusion, using advanced monitoring techniques and awake intubation to minimize risks, resulting in a smooth recovery with no new neurological deficits.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!