• S Dohi, S Inomata, M Tanaka, Y Ishizawa, and N Matsumiya.
• Department of Anesthesiology, University of Tsukuba, Ibaraki, Japan.
• J Clin Anesth. 1990 Nov 1;2(6):415-9.

Study ObjectiveTo test the usefulness of the end-tidal carbon dioxide monitor in facilitating awake blind nasotracheal intubation in patients with potentially difficult airways.DesignRandomized, controlled comparison of regimen.SettingInpatient surgery clinic at a university hospital.PatientsSixty-one consecutive patients with potentially difficult airways.InterventionsAfter airway anesthesia with 4% lidocaine was administered to all patients, either fentanyl and diazepam (n = 30) or fentanyl alone (n = 31) was given intravenously before the awake blind nasotracheal intubation procedure.Measurements And Main ResultsEnd-tidal carbon dioxide concentration, arterial blood pressure, heart rate, and arterial oxygen saturation (by pulse oximeter) were measured in each patient during the awake blind nasotracheal intubation procedure. The day after anesthesia and surgery, each patient was asked to assess the degree of discomfort experienced during the procedure. In 54 of 61 patients, the end-tidal carbon dioxide monitor facilitated awake blind nasotracheal intubation. End-tidal carbon dioxide was significantly higher in patients given both fentanyl and diazepam than in those given fentanyl alone (7.4% +/- 1.4% vs 5.9% +/- 0.9%, respectively; p less than 0.05), but no patient in either group recalled the awake intubation as extremely uncomfortable.ConclusionsMonitoring of end-tidal carbon dioxide is useful and valuable in both facilitating blind nasotracheal intubation and avoiding profound hypoventilation.

24 keywords...

hide…