A COMPARATIVE STUDY BETWEEN TWO MONITORING TECHNIQUES OF AWAKE BLIND NASAL INTUBATIONS IN CASES OF RESTRICTED MOUTH OPENING

Bipin K Shah, Dhara Shah, Hitesh Chelani, Krishna Shah, Sanjay Baldaniya, Indu A Chadha
2020 Indian journal of applied basic medical sciences  
Intubating a patient with limited or nil mouth opening is always a challenge, particularly when fibreoptic laryngoscope is not available. Awake Blind Nasotracheal Intubation[ABNI] is one of the options for intubating such patients. It requires sufficient patient cooperation and comfort. Presently available short acting analgesics and amnesias are excellent choices for this exercise. Aims: The present study was to compare the two techniques while performing nasotracheal intubation: monitoring by
more » ... tion: monitoring by spontaneous respiratory movement in rebreathing bag of breathing circuit, with monitoring by EtCO2 tubing attached to breathing circuit while performing [ABNI]. Study Design: This prospective randomized study of 60 patients undergoing Commando surgery with anticipated difficult airway. They were randomly assigned into two groups of 30 each according to the method used for [ABNI]. After complete airway block, Group (A) patients were monitored by spontaneous respiratory movement in rebreathing bag of breathing circuit while performing [ABNI] and while Group (B) patients were monitored by EtCO2 tubing attached to breathing circuit while performing [ABNI]. 20 patients were intubated at first attempt, 6 at second and 4 patients at third attempt in Group A, while 21were intubated at first, 5 at second and 4 at third attempt in Group B. These differences were insignificant. The mean time required for successful intubation was in Group A (2.47± 0.068) min. and in Group B (2.42±0.057) min. which was insignificant. Also, success rate, hemodynamic changes and complications and severity score were comparable in both groups. In conclusion: This study showed that both the techniques in performing [ABNI] are equally valuable. There was no significant difference between the success rates of both techniques. [ABNI] under topical anesthesia may provide an alternative safe method in anticipated difficult intubation, particularly if fiberoptic bronchoscope is not available.
doi:10.26860/ijabms.2020.22/b.35.9 fatcat:bqdzrbiqlfaapolocgkdpff2iq