Oesophageal naso-pharyngeal catheter use for airway management in patients for awake craniotomy.

In asleep-awake-asleep anaesthesia, removal and reinsertion of endotracheal tubes are associated with significant difficulty and risk. To overcome this, an oesophageal naso-pharyngeal catheter was developed. Its sealed distal end is placed in the oesophagus via the nose and the proximal end is connected to a ventilator or breathing circuit. For anaesthesia, the distal end balloon is inflated to seal the oesophagus and the larger proximal balloon is inflated to seal the naso- and oro-pharyngeal cavities. Ventilation occurs via the side holes on the tube located between the balloons and which sit over the laryngeal inlet. This eliminates the need to remove and reestablish airway devices with the associated risks. The authors report the preliminary experience using this device in 17 patients who underwent awake craniotomy for surgery adjacent to the 'eloquent' areas.