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Ann Fr Anesth Reanim · Feb 2003
Clinical Trial[Fiberoptic intubation in adult patients with predictive signs of difficult intubation: inhalational induction using sevoflurane and an endoscopic facial mask].
- J C Favier, M Da Conceiçao, G Genco, I Bidallier, M Fassassi, T Steiner, and R Pitti.
- Service de réanimation polyvalente, département d'anesthésie-réanimation-urgences, HIA Legouest, BP10, 57998, Metz-Armée, France. legouest.daru@dial.oleane.com <legouest.daru@dial.oleane.com>
- Ann Fr Anesth Reanim. 2003 Feb 1; 22 (2): 96-102.
ObjectiveTo evaluate the combination of inhalational induction with sevoflurane and fiberoptic intubation through a specific facial mask for anticipated difficult tracheal intubation (DI) in adults.Study DesignProspective study.Patients And MethodsEighteen consecutive patients at risk of DI. After premedication made of hydroxyzine 2 mg x kg(-1), preoxygenation, 0.1 microg x kg(-1) sufentanil was administered (T0), then, inhalational induction was started: sevoflurane 8% in 100% O2 l x min(-1). After 1 min, sevoflurane was decreased to 5% and, if necessary, adapted to obtain an adequate depth of anaesthesia (Ramsay score > 3). Fiberoptic bronchoscopy was performed through a Fibroxy mask. BP was measured every 2.5 min, HR, SpO2, RR were recorded. The results were analyzed by Newman-Keuls test.ResultsIntubation was easily realized but it was necessary to assist ventilation in patients presenting prolonged apnea lasting more than 30 s (5 out of 9 patients who presented apnea during procedure). Intubation was quickly realized (T+ 4 +/- 3 min). Haemodynamics and saturation were not altered during procedure. Inhalatory induction using sevoflurane costs 6 10 versus 16 80 for intravenous target controlled propofol anesthesia (using only one preconditionned syringe).ConclusionInhalational induction with sevoflurane and fiberoptic intubation appeared easy, fast and cheap.
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