Awake fiberoptic nasotracheal intubation for patients with difficult airway
Tsukamoto Masanori, Hitosugi Takashi, Yokoyama Takeshi,
소속 상세정보
( Tsukamoto Masanori ) - Kyushu University Hospital Department of Dental Anesthesiology
( Hitosugi Takashi ) - Kyushu University Faculty of Dental Science Department of Dental Anesthesiology
( Yokoyama Takeshi ) - Kyushu University Faculty of Dental Science Department of Dental Anesthesiology
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.
키워드
Conscious Sedation; Fiberoptic Nasotracheal Intubation; Topical Anesthesia
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