The patient was placed in the sniffing position, head elevated by a ramp under shoulders, and O2 was given by a nasal catheter at 4 l/min.
Remifentanil administered by target-controlled infusions (TCI) (OrchestraⓇ Base Primea, Fresenius Kabi, Brezins, France) with the Minto pharmacokinetic model 12 that adjusts for age, weight, and sex. Ramsay sedation scale (RSS) 13 was used to assess the level of patient sedation. The target RSS was a score of 3 (responsive to commands only). The primary target concentration of …show more content…
If severe gagging or coughing had been noted, the scope was removed and remifentanil titrated higher and a wait for 90 seconds before reattempting intubation.
Tracheas have been intubated with Flex-Tip tracheal tubes (Parker Medical, Highlands Ranch CO, USA) size 7.0 for women and size 7.5 for men. The tube was placed over FOB in FOB group or over a 60º hockey stick stylet in GVL group.
To minimize the effect of operator inexperience, intubation was done by one of the two investigators who had greater than 100 times successful intubation with either FOB or GVL. Two anesthetists were present during procedure: one for the awake intubation and the other for observation and data collection. end tidal capnogram).We also recorded the number of intubation attempts, the best glottic view obtained by the Cormack and Lehane scoring system14, the response to intubating device and the lowest saturation during the intubation. On the first postoperative day, patients have been asked if they had post-operative hoarseness and / or sore throat and patient satisfaction had been assessed according to the following score (excellent =1, good =2 and fair = …show more content…
After three attempts the procedure was considered failed, the study protocol was stopped and intubation under inhalational induction with FOB without neuromuscular block (plan B) is carried out and patient to be excluded from the