title: Remifentanil as single agent to facilitate awake fibreoptic intubation in the absence of premedication.
abstract: Remifentanil is increasingly being used as the primary agent to provide sedation during awake fibreoptic nasal intubation. In this observational study, we aimed to determine the optimal effect site concentration of remifentanil, using a target controlled infusion based on the Minto pharmacological model, to provide optimal safe intubation conditions without the use of other sedatives/premedication and/or spray-as-you-go local anaesthesia. Twenty patients with anticipated difficult airway participated in the study. Good intubating conditions were achieved in all patients with mean (SD) effect site concentration of 6.3 (3.87) ng.ml(-1) of remifentanil recorded at nasal endoscopy and 8.06 (3.52) ng.ml(-1) during tracheal intubation. No serious adverse event occurred during any of these procedures. These preliminary findings suggest that this is a feasible and safe technique for awake fibreoptic nasal intubation.
authors: Department of Anaesthesia, University Hospital Aintree, Liverpool, UK. vennibala@hotmail.com
authors: R
authors: R
authors: Vennila
authors: A
authors: A
authors: Hall
authors: M
authors: M
authors: Ali
authors: N
authors: N
authors: Bhuiyan
authors: D
authors: D
authors: Pirotta
authors: D A
authors: DA
authors: Raw
mesh_terms: D000293:Adolescent; D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D011292:Premedication; D000077208:Remifentanil; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil