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Airway anesthesia: theory and practice.

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Anesthesiology Clinics
|May 23, 2015
PubMed
Summary

Topical airway anesthesia using lidocaine is essential for awake intubation. Techniques include airway blocks, "spray as you go," and nasal topicalization with vasoconstrictors, often with sedation.

Keywords:
Airway anesthesiaAirway blocksAwake intubationBenzocaine toxicityFiber optic intubationLidocaine toxicityLocal anesthesiaTopical anesthesia

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Area of Science:

  • Anesthesiology
  • Airway Management

Background:

  • Topical anesthesia is crucial for awake intubation procedures.
  • Lidocaine is the primary anesthetic agent used for airway topicalization.

Purpose of the Study:

  • To outline common methods for achieving effective topical anesthesia of the airway.
  • To describe techniques facilitating patient tolerance during awake intubation.

Main Methods:

  • Utilizing various delivery methods for lidocaine, including "spray as you go" techniques.
  • Employing airway blocks as an alternative or adjunct to topical anesthesia.
  • Incorporating vasoconstrictors for nasal intubation topicalization.

Main Results:

  • Successful topicalization allows for easy tolerance of oral airways during awake oral intubation.
  • Nasal intubation requires specific topicalization of nasal passages with a vasoconstrictor.
  • Judicious sedation is commonly integrated into awake intubation protocols.

Conclusions:

  • Effective airway topicalization is a cornerstone of successful awake intubation.
  • A combination of techniques ensures patient comfort and procedural success.
  • Sedation plays a significant role in optimizing the awake intubation experience.