Comparison between Fibreoptic and Blind Nasotracheal Intubation Criteria in Awake Surgical Patients

This work was designed to compare the applicability of awake blind nasal and that of fibreoptic nasotracheal intubation in thirty adult sedated patients (ASA I and II) in whom the trachea planned to be intubated nasally. They were scheduled for elective oral or maxillofacial surgery under general anaethesia. They were randomly assigned into two equal groups according to the method used for intubation (n=15per group). After complete airway block, group (I) patients were intubated using blind nasal technique, while group (II) patients were intubated using fibreoptic technique. Twelve patients were intubated at first attempt, two at second and one patient at third attempt in blind nasal group, while eleven intubated at first, three at second and one at third attempt in the fibreoptic group. These differences were insignificant. The mean time required for successful intubation was significantly less in blind nasal group (83.1 ± 12.5) seconds than in fibreoptic group (97.5 ± 17.1) seconds. Also, success rate, heamodynamic changes and adverse events were comparable in both groups. In conclusion: this study showed that blind nasal and fibreoptic nasotracheal intubation are valuable techniques in awake sedated patients. There was no significant difference between the success rate of both techniques. Blind nasal intubation under topical anesthesia may provide an alternative safe method in cases of anticipated difficult intubation, particularly if fibreoptic bronchoscope is not available or failed to pass through the glottis as the view is obscured by blood and/or secretions.