Fiberoptic endotracheal intubation after topicalization with

Anesthesia and analgesia · May 2004

Clinical Trial

Fiberoptic endotracheal intubation after topicalization with in-circuit nebulized lidocaine in a child with a difficult airway.

This case report describes the successful fiberoptic intubation of an uncooperative child with a difficult airway due to gross burn scarring in the facial and neck region by administering 4% end-tidal sevoflurane and simultaneously delivering 4% nebulized lidocaine via a small-volume nebulizer that was connected to the inspiratory limb of the circle system via a T-piece adapter. This case suggests that simultaneously administering a volatile anesthetic with nebulized lidocaine might be an alternative way to deliver lidocaine and might provide better topical anesthesia for uncooperative patients. ⋯ An in-circuit nebulization system to deliver topical lidocaine may facilitate fiberoptic-assisted intubation in anesthetized, spontaneously breathing children with compromised airways.

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- Ban C H Tsui and Kirsten Cunningham.
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada. btsui@ualberta.ca
- Anesth. Analg. 2004 May 1; 98 (5): 1286-8, table of contents.
UnlabelledThis case report describes the successful fiberoptic intubation of an uncooperative child with a difficult airway due to gross burn scarring in the facial and neck region by administering 4% end-tidal sevoflurane and simultaneously delivering 4% nebulized lidocaine via a small-volume nebulizer that was connected to the inspiratory limb of the circle system via a T-piece adapter. This case suggests that simultaneously administering a volatile anesthetic with nebulized lidocaine might be an alternative way to deliver lidocaine and might provide better topical anesthesia for uncooperative patients.ImplicationsAn in-circuit nebulization system to deliver topical lidocaine may facilitate fiberoptic-assisted intubation in anesthetized, spontaneously breathing children with compromised airways.

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Fiberoptic endotracheal intubation after topicalization with in-circuit nebulized lidocaine in a child with a difficult airway.

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