Training course in local anaesthesia of the airway and fibreoptic intubation using course delegates as subjects.

Abstract

We describe a practical method of training anaesthetists in the technique of awake fibreoptic intubation. This is performed on a training course using the delegates as subjects. The first 15 subjects underwent cardiovascular monitoring during airway fibreoptic endoscopy performed by other course members. They were subsequently interrogated by use of a questionnaire. Evidence from questionnaires suggests this method of instruction is acceptable in this self-selected group of individuals. Gagging was the commonest unpleasant side-effect of airway endoscopy, although only one delegate rated this as uncomfortable. Fifty-four per cent of subjects found the procedure slightly painful; 46% reported no pain at all. Overall, the procedure was rated as acceptable by 85% of subjects and enjoyable by 15% of subjects. No delegate found endoscopy or intubation distressing. Cardiovascular monitoring revealed pulse rate and arterial pressure changes of less than 25% of baseline values. Paraesthesia developed in one individual and nasal bleeding in two cases, neither of which was clinically significant and did not interfere with endoscopy. The use of course delegates as subjects for training was acceptable to anaesthetists and is associated with a low level of discomfort and morbidity.