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Awake intubation made easy and acceptable
1Department of Anaesthesia, Queen Elizabeth Hospital, Woodville, South Australia.
Anaesthesia and Intensive Care
|November 30, 2000
Summary
A novel aerosolized lignocaine technique for nasal, pharyngeal, and laryngeal administration improved endotracheal intubation conditions. This method was well-tolerated, safe, and effective in unsedated volunteers.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Effective topical anesthesia is crucial for airway procedures like endotracheal intubation.
- Traditional methods may have limitations in efficacy or patient tolerance.
Purpose of the Study:
- To evaluate the efficacy and safety of aerosolized lignocaine administered via a simple device for endotracheal intubation in unsedated volunteers.
Main Methods:
- A custom device using an Optiva cannula and oxygen supply delivered aerosolized lignocaine to the nose, pharynx, and larynx.
- Ten unsedated, unpremedicated volunteers underwent intubation following lignocaine administration.
- Plasma lignocaine concentrations and hemodynamic stability were monitored.
Main Results:
- Mean intubation time was 12 minutes (range 8-19 minutes) after lignocaine administration.
- Intubating conditions were rated as good and the procedure was well-tolerated by all subjects.
- Mean lignocaine dose was 4.8 mg/kg, with plasma concentrations below toxic levels and stable hemodynamics without desaturation.
Conclusions:
- Aerosolized lignocaine delivered via a simple device provides effective topical anesthesia for endotracheal intubation.
- This technique offers a safe and well-tolerated alternative for airway management in awake patients.