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Updated: Aug 25, 2026

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
[Study on midazolam used for awake blind intubation of maxillofacial surgery]
1Department of Anesthesiology, Ninth People's Hospital,Shanghai Second Medical University. Shanghai 200011, China.
Objective:
To provide clinical data for midazolam to be used as an assistant drug for awake tracheal intubation.
Methods:
40 cases for maxillofacial surgery were selected and divided into 2 groups randomly with each group 20 cases. All cases received awake intubation using blind tracheal intubation instrument 5 minutes before intubation, patients in group 1 were administered fentanyl 4 microg/kg and midazolam 0.04 mg/kg by vein,patients in group 2 were only injected fentanyl 4 microg/kg. The changes of sedation score (Ramsay score), bispectral analysis of electroencephalogram (BIS), heart rate (HR), mean artery pressure (MAP), respiration rate (RR), blood oxygen saturation of pulse (SpO(2)) and the incident rate of amnesia in the two groups at T1 (before administering drug), T2 (just before starting intubation), T3 (when oesophagus tracheal introducer was just located properly), T4 (when light cable was just inserted into tracheal) and T5 (when tracheal tube was just inserted into tracheal) were observed.
Results:
(1) To be compared with T1, Ramsay score increased and BIS decreased obviously (P<0.05) in group 1 after T2. (2) To be compared with T1, MAP and HR rose significantly (P<0.05) in group 2 after T3. (3) After T3, RR was obviously lower than T1 (P<0.05) in the two groups,but there was no change in SpO(2). The incident rate of amnesia for intubation procedure was 65% in group 1, and it was remarkly greater than that in group 2 (P<0.05).
Conclusion:
Midazolam can produce a good effect of sedation and anterograde amnesia, it is a proper assistant drug for awake intubation.
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