Difficult Intubation-Moving Away from Conventional Anesthesia in Difficult Airway

Moving Away from Conventional Anesthesia in Difficult Airway

Despite the outstanding improvement of pharmaceuticals and advanced instrumental technology, difficult airway, and awake intubation is still a dilemma.

Encountering a patient with a predicted critical airway is usually suggestive of unpleasant experience of an under-sedated or over-sedated patient and a challenging attempt to achieve a patent airway by the anesthetist.

Inappropriate sedation is a common event in the scenario of awake intubation and is actually accompanied by the unpleasant experience of the patient which is the most important cause of patient refusal for subsequent trials for awake intubation.

Prevention of morbidity and mortality in patients with predicted difficult airway relies on providing a safe and secure anesthesia by maintaining spontaneous ventilation and prevention of oversedation.

Inability to provide an appropriate sedation is among various causes of underused awake fiberoptic intubation (AFOI) in UK . Achieving a balance between under sedation and oversedation is a real challenge with conventional anesthesia methods.

Different anesthetics used for sedation in difficult airway showed the potential to produce fatal respiratory depression or airway collapse.

The disadvantage of Midazolam as a common sedative agent and Propofol as a commonly used hypnotic agent in awake intubation is the low safety margin and the likelihood of disastrous nonreversible respiratory depression or apnea.

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Then the concept of “peaceful awake intubation” is not a pipe dream anymore.

This article Published in International Journal of Anesthesiology & Research by SciDoc Publishers.