Awake flexible intubation is the gold standard for difficult airway management but failures have been reported in up to 13% of cases. A novel technique called 'awake fibrecapnic intubation', developed in the Netherlands, is described here for the intubation of patients with head and neck cancer who have a difficult airway. After topical anaesthesia is administered, a flexible fibrescope is introduced into the pharynx. A special suction catheter is then advanced through the suction channel of this scope and then into the airway for the recording of carbon dioxide measurements. The catheter may also be used for oxygenation during the procedure. Spontaneous respiration is maintained in all patients. When four capnograms have been obtained, the flexible scope is railroaded over the catheter and after identification of tracheal rings or carina, the tracheal tube is placed. This new intubation technique is easier to learn than awake flexible intubation.
|Journal||Nederlands Tijdschrift voor Geneeskunde|
|Publication status||Published - 1 Dec 2011|