Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Optimal airway management by the anaesthetist is particularly critical in neurosurgical patients. Standard intubation attempts may fail or have deleterious effects on cerebral dynamics so awake fibreoptic intubation is often the most suitable option for tracheal intubation. ⋯ Current practice and evidence for the use of the technique are reviewed and contraindications and complications discussed. A description of a typical awake fibreoptic intubation method is given with reference to the neurosurgical implications of local anaesthesia, sedation and the autonomic and neurophysiological responses that may occur.