Upper Airway Anesthesia Techniques and Sedation Strategies for Awake Fiberoptic Intubation: A Novel Workshop for...

Awake fiberoptic intubation (AFOI) is a critical skill for anesthesia providers but infrequent exposure complicates learning from clinical exposure alone. This workshop teaches anesthesia residents upper airway anesthesia techniques and sedation strategies using low-cost, ultrasound-compatible, novel ballistic-gel phantom task trainers for superior laryngeal nerve (SLN) and transtracheal blocks.

We developed a 3-hour workshop consisting of slide sets, breakout sessions, and task trainers for anesthesiologists to teach second- and third-year clinical anesthesiology residents. We created novel ballistic-gel phantom trainers using 3-dimensional printing and silicone molds. We assessed residents' prior experience, satisfaction, and changes in knowledge and self-efficacy from pre- to postworkshop and from postworkshop to 1-year follow-up, using anonymous paper surveys.

Twenty-five (40%) of 63 residents submitted surveys across 2024-2025. Knowledge scores (maximum 5 points) improved from a mean (SD) of 2.8 (1.3) to 4.0 (0.8), P < .001; mean increase of 1.1 [95% CI, 0.6 to 1.7]). Self-efficacy for counseling patients (P = .003), designing an appropriate sedation strategy (P = .006), performing SLN blocks (P < .001), and performing transtracheal nerve blocks (P < .001) all improved postworkshop. Thematic analysis showed residents considered the gel phantoms realistic and useful for learning anatomy and landmarks for these nerve blocks. Residents were highly satisfied with the workshop, rating it 4.9 (0.3) out of 5 points.

Incorporating gel phantoms is effective at improving anesthesia residents' knowledge and self-efficacy with sedation strategies and upper airway anesthesia techniques for AFOI, including both landmark and ultrasound-guided nerve block techniques.