Topical anaesthesia of the vocal cords by nebulized lignocaine inhalation to facilitate fi breoptic nasotracheal intubation in a head-size parotid tumour patient

Abstract

This case report describes a successful fi breoptic naso-tracheal intubation in a patient with difficult airway due to a nearly head-size right parotid swelling. Nasal fi breoptic intubation was performed by maintaining spontaneous breathing under propofol infusion at a dose of 25 mcg/kg/hour and topical anaesthesia of vocal cords by using oxygen (6 l/min) fl ow to nebulize 4 % lignocaine from the side port of the fi breoptic bronchoscope. The topical anaesthesia was achieved by keeping the scope in close proximity of the vocal cords and in the centre of view of the scope. This case emphasizes the possibility of fi breoptic intubation in a sedated yet spontaneously breathing patient by allowing inhalation of nebulized lignocaine during fi breoptic intubation. Keywords: fibreoptic intubation, naso-tracheal intubation, nebulized lignocaine, spontaneous breathing, topical anaesthesia.