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BJA Advance Access originally published online on April 19, 2008
British Journal of Anaesthesia 2008 100(6):850-855; doi:10.1093/bja/aen076
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Complications of awake fibreoptic intubation without sedation in 200 healthy anaesthetists attending a training course

N. M. Woodall*, R. J. Harwood and G. L. Barker

Department of Anaesthesia, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK

* Corresponding author. E-mail: nicholas.woodall{at}nnuh.nhs.uk

Background: Two hundred anaesthetists underwent airway endoscopy and attempted awake fibreoptic intubation (FOI) on a training course. Complications were recorded and each subject's response to the procedure was assessed.

Methods: Topical airway local anaesthesia was produced with up to 9 mg kg–1 of lidocaine, sedation was not used. Complications during and after the procedure were noted. Later, the subjects completed an anonymous questionnaire about anxiety, pain, coughing, and side-effects of lidocaine.

Results: More than 1300 endoscopies were performed, 180 delegates were intubated, 175 by the nasal route and five orally. Intubation was abandoned in 20 (10%) subjects. Nasal bleeding occurred in 20 (10%) subjects. Symptoms that could be attributed to lidocaine were reported by 71 (36%) subjects. Afterwards, two (1%) subjects experienced rigors and one developed a lower respiratory tract infection.

Conclusions: Nasendoscopy and FOI under local anaesthesia are associated with complications, notably those of infection and airway trauma. Side-effects potentially attributable to lidocaine administration were commonly reported.

Keywords: airway, complications; anaesthetic techniques, local, fibreoptic; education


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[Abstract] [Full Text] [PDF]

E-letters:

Read all E-letters

Sedation and airway local anaesthesia for awake fibreoptic tracheal intubation
Fu-Shan Xue, et al.
British Journal of Anaesthesia, 9 Jun 2008 [Full text]
An anaesthetic school’s interest in awake fibreoptic intubation training
Ben W Howes, et al.
British Journal of Anaesthesia, 16 Jun 2008 [Full text]
Complications of awake fibreoptic intubation - a comment from outside the square.
Michael B. Hooper
British Journal of Anaesthesia, 1 Jul 2008 [Full text]
Sedation and airway local anaesthesia for awake fibreoptic tracheal intubation. Response to Drs Xue,
Nicholas M Woodall, et al.
British Journal of Anaesthesia, 10 Jul 2008 [Full text]
Barriers to fibreoptic intubation
Andrew F Smith, et al.
British Journal of Anaesthesia, 15 Jul 2008 [Full text]
A comment from outside the square. A reply
N M Woodall, et al.
British Journal of Anaesthesia, 20 Jul 2008 [Full text]
Re: A comment from outside the square. A reply
Michael B. Hooper
British Journal of Anaesthesia, 27 Aug 2008 [Full text]
Re: Barriers to fibreoptic intubation. - A reply
Nicholas M Woodall, et al.
British Journal of Anaesthesia, 24 Oct 2008 [Full text]

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