Patients' experience of awake versus anaesthetised orotracheal intubation: a controlled study

We investigated patients' self-reported experience following awake flexible fibreoptic tracheal intubation and compared this to the experience of matched patients who had undergone conventional tracheal intubation under general anaesthesia for the same type of surgical procedure.

Patients suspected of having, or known to have, a difficult airway underwent flexible fibreoptic orotracheal intubation with topical anaesthesia and sedation. A matched group of patients who underwent tracheal intubation conventionally following induction of general anaesthesia were identified in our database and questionnaires were mailed to the patients at a median of 15 months after the procedure.

One hundred and ten patients completed the questionnaire. Feelings of discomfort, sensation of suffocation and hoarseness were reported by 14.6, 12.5, and 37.5%, respectively in the awake group and 0, 1.6, and 17.7%, respectively in the conventionally intubated group. No significant differences were reported between the groups with regard to sleeping disorders and the incidence of nightmares.

Temporary discomfort is encountered more frequently following awake orotracheal intubation than after conventional intubation, but we did not find a difference in long-term problems such as sleeping disorders or nightmares.