Despite recent advancements in video and digital laryngoscopes, awake intubation continues to be an important modality for anesthesiologists to secure the airway. Awake intubation (AI) can be performed for a variety of conditions that can result in a difficult airway. Congenital anomalies involving the head and neck, tumors of the airway, morbid obesity, cervical spine pathology, and trauma associated with facial and cervical instability all make direct laryngoscopy challenging and can be indications for awake intubation.
Awake intubation Laryngoscopy Difficult tracheal intubation Topicalization Local anesthetic Transtracheal nerve block Trans laryngeal block
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The authors would like to acknowledge Valeriy V. Kozmenko, M.D. for the photography that appears in the chapter.
Rosenstock CV, Thøgersen B, Afshari A, Christensen AL, Eriksen C, Gätke MR. Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management. Anesthesiology. 2012;116(6):1210–6.CrossRefPubMedGoogle Scholar
Ajay S, Singhania A, Akkara AG, Shah A, Adalja M. A study of flexible fiberoptic bronchoscopy aided tracheal intubation for patients undergoing elective surgery under general anesthesia. Indian J Otolaryngol Head Neck Surg. 2013;65(2):116–9.CrossRefPubMedGoogle Scholar
Mu L, Sanders I. Sensory nerve supply of the human oro- and laryngopharynx: a preliminary study. Anat Rec. 2000;258(4):406–20.CrossRefPubMedGoogle Scholar
Finucane BT, Tsui BCH, Santora AH. Principles of airway management. Springer: New York, NY; 2011.CrossRefGoogle Scholar
Avitsian R, Lin J, Lotto M, Ebrahim Z. Dexmedetomidine and awake fiberoptic intubation for possible cervical spine myelopathy: a clinical series. J Neurosurg Anesthesiol. 2005;17(2):97–9.CrossRefPubMedGoogle Scholar
Alvis BD, King AB, Hester D, Hughes CG, Higgins MS. Randomized controlled pilot trial of the rigid and flexing laryngoscope versus the fiberoptic bronchoscope for intubation of potentially difficult airway. Minerva Anestesiol. 2015;81(9):946–50.PubMedGoogle Scholar
Baptista R, Silva S, Dias P, Monteiro P, et al. In-hospital prescription of QT-prolonging drugs in a cohort of more than 100,000 patients. Int J Cardiol. 2011;147(1):165–6.CrossRefPubMedGoogle Scholar