Complications of awake fibreoptic intubation without sedation in 200 healthy anaesthetists attending a training course.
BACKGROUND
Two hundred anaesthetists underwent airway endoscopy and attempted awake fibreoptic intubation (FOI) on a training course. Complications were recorded and each subject's response to the procedure was assessed.


METHODS
Topical airway local anaesthesia was produced with up to 9 mg kg(-1) of lidocaine, sedation was not used. Complications during and after the procedure were noted. Later, the subjects completed an anonymous questionnaire about anxiety, pain, coughing, and side-effects of lidocaine.


RESULTS
More than 1300 endoscopies were performed, 180 delegates were intubated, 175 by the nasal route and five orally. Intubation was abandoned in 20 (10%) subjects. Nasal bleeding occurred in 20 (10%) subjects. Symptoms that could be attributed to lidocaine were reported by 71 (36%) subjects. Afterwards, two (1%) subjects experienced rigors and one developed a lower respiratory tract infection.


CONCLUSIONS
Nasendoscopy and FOI under local anaesthesia are associated with complications, notably those of infection and airway trauma. Side-effects potentially attributable to lidocaine administration were commonly reported.
Woodall
N M
NM
Department of Anaesthesia, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. nicholas.woodall@nnuh.nhs.uk
Harwood
R J
RJ
Barker
G L
GL
D000772:Anesthesia, Local / Q000379:methods; D000776:Anesthesiology / Q000193:education*; D000779:Anesthetics, Local / Q000009:adverse effects; D001364:Awareness; D016292:Procedural Sedation; D004502:Education, Medical, Continuing / Q000379:methods*; D004844:Epistaxis / Q000209:etiology; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000379:methods; D008012:Lidocaine / Q000009:adverse effects; D009296:Nasal Cavity / Q000293:injuries
D000779:Anesthetics, Local; D008012:Lidocaine