Comparison between blind nasal and fiber optic intubation in maxillofacial trauma posted for elective surgery

Abstract

Background: Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient's survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient's airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Aim: To compare the safety and complications of blind nasal and fiber optic intubation in maxillofacial trauma. Materials and methods: This is an observational study, approved by the institutional ethical committee. An individual informed consent was taken from all the patients selected for the study. All the patients belonging to ASA grade 1 and 2, between the age group of 18 to 50 years of either sex. Posted for maxillofacial surgery under general anesthesia patients with comorbidities like copd, cardiovascular problems, patient refusal are excluded from the study. Total 40 patients with different types of facial fractures are included in the study they were divided into blind nasal group (20 patients) and fiberoptic group (20 patients). Discussion: The patient with maxillofacial trauma presents serious challenges for the physician because airway management in these patients can be complicated by their injury. The first challenge is to secure the airway for sufficient and effective breathing and/or ventilation. Fiberopticbronchoscopic intubation is best option for elective patients but has been considered difficult in maxillofacial trauma, patients with intraoral bleed. In both group of patients, securing the airway before induction of general anesthesia adds to the safety of anesthesia and helps minimize possibility of major complications. Conclusion: Awake fiberoptic intubation, is the best method for securing airway in patients with facial trauma when compared with blind nasal intubation.