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Evaluating the utility of pre-operative airway assessment for intubation management in difficult airway patients

Published online by Cambridge University Press:  23 October 2020

S Narula ,
D S Mann ,
N Sadana  and
N R Vasan
S Narula
Affiliation:
University of Oklahoma College of Medicine, Oklahoma City, USA
D S Mann
Affiliation:
Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
N Sadana
Affiliation:
Department of Anesthesiology, Tufts University School of Medicine, Boston, Massachusetts, USA
N R Vasan*
Affiliation:
Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
*
Author for correspondence: Nilesh R Vasan, Department of Otolaryngology, University of Oklahoma Health Sciences Center, 800 Stanton L Young Blvd, Suite 1400, Oklahoma City, OK73104, USA E-mail: [email protected]
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Abstract

Objective

To assess intubation management in difficult airway patients by performing a multidisciplinary pre-operative examination of the airway using a flexible fibre-optic laryngoscope.

Methods

Patients with a known but stable difficult airway were evaluated prior to surgery in the pre-operative holding suite by both an ENT surgeon and an anaesthesiologist via a fibre-optic laryngeal examination.

Results

Performing a pre-operative fibre-optic examination of the difficult airway led to a change in intubation strategy in 6 out of 12 cases. Intubation ‘first-pass’ success occurred in 9 out of 12 (75 per cent) of our patients.

Conclusion

By performing a multidisciplinary airway examination immediately prior to surgery, a safe plan to intubate on the initial attempt was developed. This resulted in improved first-pass success at intubation compared to historical data.

Keywords

Airway ManagementIntubationGeneral AnesthesiaMultidisciplinary TeamLaryngoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 10 , October 2020 , pp. 909 - 916
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr N R Vasan takes responsibility for the integrity of the content of the paper

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