Comparison of orotracheal versus nasotracheal fibreoptic intubation in simulated cervical spine patients, under conscious sedation
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 4
Abstract
Introduction and Aims Airway management in a patient with cervical spine injury is considered a challenge Minimizing neck movement and maintaining head in neutral position is essential to prevent secondary neurological injury Flexible fibreoptic intubation causes minimal cervical spine movement In this study we evaluated and compared orotracheal and nasotracheal flexible fibreoptic intubation in a patient with simulated cervical spine injury using a cervical collar under conscious sedationMaterials and Methods Sixty patients were randomly allocated into oral and nasal groups After premedication and preperation with Xylometazoline nasal drops and lignocaine nebulization bolus fentanyl and propofol infusion was started to achieve concious sedation Flexible fibreoptic intubation was performed orally or nasally after placement of a cervical collar Operator ease and hemodynamics were moniteredResult In the oral group 867 and in the nasal group 933 first attempts were successful The ease of fibreoptic intubation was graded to be excellent in a significantly greater number of patients in the nasal group as compared to the oral group Hemodynamic variability though present was not clinically relevent this might have been secondary to use of adequate sedationConclusion The ease of fibreoptic intubation in simulated cervical spine injury under conscious sedation was found to be significantly better in the nasotracheal group Hemodynamic stability was demonstrated in both the groups in our studyKeywords Cervical spine Simulated cervical spine Fibreoptic intubation Oral fibreoptic intubation Nasal fibreoptic intubation Conscious sedation
Authors and Affiliations
Tarang Jain, Lalit Gupta, Manoj Bhardwaj
Keywords
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- EP ID EP476530
- DOI 10.18231/2394-4994.2018.0113
- Views 65
- Downloads 0
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