Awake fiberoptic orotracheal intubation: a protocol feasibility study. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Ma, Yuanyuan; Cao, Xue; Zhang, Hong; Ge, Shengjin
• Is Part Of: Journal of international medical research. Volume 49:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Awake fiberoptic intubation -- feasibility -- protocol -- sedation -- memory -- complications; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060520987395
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: To assess the feasibility of an awake fiberoptic intubation (AFOI) protocol. Methods: We enrolled 40 patients with simulated difficult intubation. The protocol consisted of conscious sedation (midazolam, 0.03 mg/kg and sufentanil, 0.1 µg/kg), regional anesthesia, and intubation. The time, first-attempt intubation success rate, hemodynamic parameters, blood oxygen saturation (SpO2 ), intubation amnesia rate, patient satisfaction, and relative complications were recorded. Results: AFOI was completed in all patients. The average total AFOI time was 14.17 ± 1.47 minutes, and the time to placing the landmark-guided bilateral superior laryngeal nerve block was 1.24 ± 0.42 minutes. The first-attempt intubation success rate was 97.5%, and patient satisfaction was 90%. Blood pressure changed (<20%) briefly after administering conscious sedation. Heart rates did not change significantly, and SpO2 remained stable and ≥95%. Three patients had a sore throat, which resolved on postoperative day 1 without other complications. On postoperative day 1, 82.5% (33/40) of the patients had no recall of AFOI, and 17.5% (7/40) had only an indistinct memory. Conclusions: The protocol was feasible with a high first-attempt intubation success rate and low complications rate. Hemodynamic parameters and respiration remained stable, with high patient satisfaction and effective amnesia.