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British Journal of Anaesthesia, 1989, Vol. 62, No. 1 13-16
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

AWAKE FIBREOPTIC INTUBATION IN THE PATIENT AT HIGH RISK OF ASPIRATION

A. OVASSAPIAN, M.D., T. C. KREJCIE, M.D., S. J. YELICH, M.D. and M. H. M. DYKES, M.D., M.ED.

Anesthesia Service, Veterans Administration Lakeside Medical Center 333 East Huron Street, Chicago, Illinois 60611, U.S.A.

Correspondence to A.O.

This report describes our experiences with 129 awake oral and nasal fibreoptic intubations in 123 patients considered to be at high risk of aspiration of gastric contents. l.v. sedation was used on all but six occasions. Local anaesthesia was applied to the larynx and trachea through the working channel of the fibrescope on 85 occasions, and by transtracheal injection on 29. Rigid laryngoscopy was necessary after fibreoptic laryngoscopy failed in one patient (with a bleeding peptic ulcer) who vomited a large amount of fresh and clotted blood. No other patient regurgitated during the procedure, and no patient developed evidence of aspiration.


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