Evaluating the utility of pre-operative airway assessment for intubation management in difficult airway patients

S Narula; D S Mann; N Sadana; N R Vasan

doi:10.1017/S0022215120002133

Evaluating the utility of pre-operative airway assessment for intubation management in difficult airway patients

J Laryngol Otol. 2020 Oct 23:1-8. doi: 10.1017/S0022215120002133. Online ahead of print.

Authors

S Narula¹, D S Mann², N Sadana³, N R Vasan²

Affiliations

¹ University of Oklahoma College of Medicine, Oklahoma City, USA.
² Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
³ Department of Anesthesiology, Tufts University School of Medicine, Boston, Massachusetts, USA.

PMID: 33092655
DOI: 10.1017/S0022215120002133

Abstract

Objective: To assess intubation management in difficult airway patients by performing a multidisciplinary pre-operative examination of the airway using a flexible fibre-optic laryngoscope.

Methods: Patients with a known but stable difficult airway were evaluated prior to surgery in the pre-operative holding suite by both an ENT surgeon and an anaesthesiologist via a fibre-optic laryngeal examination.

Results: Performing a pre-operative fibre-optic examination of the difficult airway led to a change in intubation strategy in 6 out of 12 cases. Intubation 'first-pass' success occurred in 9 out of 12 (75 per cent) of our patients.

Conclusion: By performing a multidisciplinary airway examination immediately prior to surgery, a safe plan to intubate on the initial attempt was developed. This resulted in improved first-pass success at intubation compared to historical data.

Keywords: Airway Management; General Anesthesia; Intubation; Laryngoscopy; Multidisciplinary Team.