BACKGROUND AND OBJECTIVE: The application of analgesics and sedatives during fibreoptic intubation (FOI) may result in a transient decrease in arterial oxygen saturation.This study evaluates two different techniques of FOI and respective effects on procedural duration, arterial oxygen saturation, and coughing by the patient. METHODS: Thirty-four patients received a standardized conscious sedation with fentanyl (1.5 microg kg(-1)) and midazolam (12.5 microg kg(-1)).All patients were randomly allocated to one of the following techniques: the 'vaporization' (VAP) technique included four applications of 2 ml lidocaine 2% administered through the working channel of the fibrescope supplying an oxygen flow of 3 l min(-1); the 'standard' (STAN) technique included the insufflation of 3 l(-1) min oxygen via a nasal probe and two applications of 4 ml of lidocaine 2%, each followed by a maximum of 2 min to take effect. RESULTS:FOI was successful in all patients (STAN 15; 'vaporization' 17 patients). The overall intubation time interval was significantly (P < 0.001) shorter in the VAP group. There was no difference in oxygen saturation between the two groups prior to the start of FOI, but a significant (P = 0.008) decrease in oxygen saturation levels was detected in the STAN group after completion of FOI. Patients in the VAP group coughed less; a significant difference in the number of coughs (P = 0.036) was found during the application of lidocaine into the proximal trachea. CONCLUSION: The VAP technique decreases overall intubation time, increases the oxygen saturation of the patient until completion of the intubation, and reduces cough.
RCT Entities:
BACKGROUND AND OBJECTIVE: The application of analgesics and sedatives during fibreoptic intubation (FOI) may result in a transient decrease in arterial oxygen saturation.This study evaluates two different techniques of FOI and respective effects on procedural duration, arterial oxygen saturation, and coughing by the patient. METHODS: Thirty-four patients received a standardized conscious sedation with fentanyl (1.5 microg kg(-1)) and midazolam (12.5 microg kg(-1)).All patients were randomly allocated to one of the following techniques: the 'vaporization' (VAP) technique included four applications of 2 ml lidocaine 2% administered through the working channel of the fibrescope supplying an oxygen flow of 3 l min(-1); the 'standard' (STAN) technique included the insufflation of 3 l(-1) min oxygen via a nasal probe and two applications of 4 ml of lidocaine 2%, each followed by a maximum of 2 min to take effect. RESULTS: FOI was successful in all patients (STAN 15; 'vaporization' 17 patients). The overall intubation time interval was significantly (P < 0.001) shorter in the VAP group. There was no difference in oxygen saturation between the two groups prior to the start of FOI, but a significant (P = 0.008) decrease in oxygen saturation levels was detected in the STAN group after completion of FOI. Patients in the VAP group coughed less; a significant difference in the number of coughs (P = 0.036) was found during the application of lidocaine into the proximal trachea. CONCLUSION: The VAP technique decreases overall intubation time, increases the oxygen saturation of the patient until completion of the intubation, and reduces cough.