Korean J Anesthesiol.
1991 Jun;24(3):505-509. 10.4097/kjae.1991.24.3.505.
The Chanages of Blood Pressure , Heart Rate and Cardiac Output During Awake Fiberoptic Nasotracheal and Orotracheal Intubation
- Affiliations
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- 1Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
- 2Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
- KMID: 2239276
- DOI: http://doi.org/10.4097/kjae.1991.24.3.505
Abstract
- To evaluate the clinical usefulness of fiberoptic intubation, we recorded the changes of arterial pressure, heart rate and cardiac output during fiberoptic nasotracheal and orotracheal intubation, while measuring the time taken for the intubation procedure. Anesthesia of pharynx was achieved by oral gargling of 10 ml of 4% lidocaine, and for nasotracheal intubation, nasal mucosa was anesthetized by application of 4% cocaine usirig cotton-tipped swabs. Anesthesia of the larynx and trachea was done by superior laryngeal nerve block with 6 ml of 2% lidocaine, and translaryngeal injection with 4% lidocaine by cricothyroid membrane puncture. After sedation with intravenous diazepam and fentanyl, awake fiberoptic (n=32) or orotracheal intubation (n=18) was performed on the patients (ASA class 1 or 2) in whom difficult intubation was expected. Mean arterial pressure, heart rate and cardiac output did not change significantly during intubation procedure, nor were these values significantly different between nasotracheal and orotracheal intubation group. The time taken by intubation procedure were compared, and there was no significant difference between two groups. In postoperative interviews, a few (3/28) patients complained discom-forts. It could be concluded that under approapriate anesthesia and sedation, awake fiberoptic nasotracheal or orotracheal intubation is a safe and useful approach producing minimal cardiovascular changes and discomforts.
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