A technique of awake fibreoptic intubation. Experience in patients with cervical spine disease.

Summary We report our experience of 58 patients undergoing awake fibreoptic intubation for cervical spine surgery. Topical anaesthesia was administered using a ‘spray as you go’ technique. The tracheas of 57 patients were intubated successfully. The mean time from starting topical anaesthesia to intubation was 16. l min (SEM 1.0). The procedure was associated with cardiovascular stability, a low incidence of severe cough and had a high patient acceptance. There was a low failure rate amongst trainees. The minimum mean arterial oxygen saturation was 92.9% (SEM 1.1). There was no relationship between the time taken to intubation and the episodes of desaturation or the grade oflaryngeal visibility at direct laryngoscopy. This method of producing topical anaesthesia for awake fibreoptic intubation is recommended.