• JNMA J Nepal Med Assoc · Jan 2011

    Case Reports

    Topical anaesthesia of the vocal cords by nebulized lignocaine inhalation to facilitate fibreoptic nasotracheal intubation in a head-size parotid tumour patient.

    • S Koirala, M Tripathi, A Subedi, and B Bhattarai.
    • Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
    • JNMA J Nepal Med Assoc. 2011 Jan 1;51(181):34-6.

    AbstractThis case report describes a successful fibreoptic naso-tracheal intubation in a patient with difficult airway due to a nearly head-size right parotid swelling. Nasal fibreoptic intubation was performed by maintaining spontaneous breathing under propofol infusion at a dose of 25 mcg/kg/hour and topical anaesthesia of vocal cords by using oxygen (6 l/min) flow to nebulize 4% lignocaine from the side port of the fibreoptic bronchoscope. The topical anaesthesia was achieved by keeping the scope in close proximity of the vocal cords and in the centre of view of the scope. This case emphasizes the possibility of fibreoptic intubation in a sedated yet spontaneously breathing patient by allowing inhalation of nebulized lignocaine during fibreoptic intubation.

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