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Surgeon-performed intubation in awake patients utilising an anterior commissure laryngoscope with bougie: a retrospective case series

Published online by Cambridge University Press:  31 October 2019

N R Vasan ,
E Kosik ,
B Collins  and
M Clampitt
N R Vasan*
Affiliation:
Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, USA
E Kosik
Affiliation:
Department of Anesthesiology, University of Oklahoma Health Sciences Center, USA
B Collins
Affiliation:
Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, USA
M Clampitt
Affiliation:
Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, USA
*
Author for correspondence: Dr Nilesh R Vasan, College of Medicine Building, 800 Stanton L Young Blvd, Suite 1400, Oklahoma City, Oklahoma 73104, USA E-mail: Nilesh-Vasan@ouhsc.edu
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Abstract

Objective

This retrospective case series examined the outcomes of surgeon-performed intubation using the anterior commissure rigid laryngoscope and bougie in adults with a difficult airway, including awake patients.

Methods

This study comprised a series of adult patients who underwent surgeon-performed intubation over a 10-year period. They were identified by a records search for the Current Procedural Terminology (‘CPT’) code 31500 – ‘intubation by surgeon’.

Results

Forty-nine intubations performed in the operating theatre were reviewed. Intubation performed by the surgeon using the rigid anterior commissure laryngoscope was successful in 47 of the cases (96 per cent). Over half of the patients had experienced failed intubation attempts with other methods by other providers prior to the surgeon performing direct laryngoscopy. Twenty intubations were performed without paralytics and with the patient awake.

Conclusion

In properly selected adults who need an urgent, secure airway in the operating theatre, surgeon-performed anterior commissure laryngoscopic intubation using a bougie should be considered a safe, reliable procedure. In most cases, this procedure can be performed in selected patients whilst awake, with sedation.

Keywords

Intubation, IntratrachealLaryngoscopyDexmedetomidine
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 11 , November 2019 , pp. 986 - 991
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr N R Vasan takes responsibility for the integrity of the content of the paper

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