Abstract
An: 2020, Nr.3, Articol Nr. 7
Title: 

REGIONAL AND TOPICAL ANESTHESIA FOR AWAKE ENDOTRACHEAL INTUBATION

Authors: 

      Otilia Boişteanu - “Grigore T.Popa” University of Medicine and Pharmacy, Iasi, Faculty of Medical Dentistry, Department of Anesthesiology
      M.L. Ciofu - “Grigore T.Popa” University of Medicine and Pharmacy, Iasi, Faculty of Medical Dentistry, Department of Oral and Maxillo-Facial Surgery
      Delia Hanganu, M.V. Hanganu - “Grigore T.Popa” University of Medicine and Pharmacy, Iasi, Faculty of Medicine, Department of Anatomy
      L.V. Hartie - Faculty of Medicine, Department of Anatomy, Department of Anesthesiology
      Lidia Cureniuc - “St. Spiridon” Hospital Iasi, Department of Anesthesiology
      Maria Paula Comanescu - “St. Spiridon” Hospital Iasi, Department of Surgery
      REGIONAL AND TOPICAL ANESTHESIA FOR AWAKE ENDOTRACHEAL INTUBATION (Abstract): Direct laryngoscopy with the insertion of a tracheal probe through the vocal cords is a routine procedure for general anesthesia. However, there may be certain anatomical conditions, pathologies of airways, polytraumas, morbid obesity, where viewing the glottis by direct laryngoscopy may be difficult or impossible, a case in which the anesthesiologist recognizes it and defines it as a difficult airway. The recommendation for awake intubation addresses to the cases of difficult airways to which anesthesia and/or muscle relaxation may lead to the case of “cannot ventilate, cannot intubate”. The method described is safe and efficient and can be advised for the cases in which there are serious doubts regarding the possibility of maintaining the airways open during the inducing of anesthesia or for the cases in which the intubation failed during prior anesthesia. The intubation of an awake patient is rarely associated with severe desaturation episodes and is usually well tolerated by motivated patients. Consequently, the neuroanatomy of the upper airways is presented in this article with the description of several techniques that can be used for the anesthesia of the airways for intubation. These techniques include local anesthesia by direct application on the respiratory mucosa as well as the description of some types of nerve blocks.
Key words: LOCAL ANESTHESIA, AWAKE INTUBATION, DIFFICULT GENERAL ANESTHESIA
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