This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Boyce, J. R. Search for Related Content PubMed PubMed Citation Articles by Boyce, J. R.

Effectiveness of transnasal jet ventilation – a teaching aid

Birmingham, Alabama

To the Editor:

We have developed a technique of transnasal jet ventilation to facilitate resident education in the area of fiberoptic intubation.

The patients selected are scheduled for oromaxillofacial surgical procedures with a nasal endotracheal tube. This technique is used only in patients in whom the airway evaluation (oropharyngeal classification, head extension, and hyomental distance) predicts easy intubation, and are free of pathology that is obstructive or potentially obstructive to the airway.

After preoxygenation and application of appropriate monitors, selected patients undergo induction of general anesthesia with sodium thiopental, 3–5 mg•kg^–1, fentanyl 3–4 µg•kg^–1 and rocuronium 0.6 mg•kg^–1. Lidocaine 1.5 mg•kg^–1 and glycopyrrolate 0.4 mg•kg^–1 are also administered. Phenylephrine nose drops, 0.25% are applied to each nasal cavity. A #7 silastic nasopharyngeal airway, well lubricated with 2% lidocaine jelly is introduced into the nasopharynx through one nostril (Figure). Mask ventilation is resumed and a propofol infusion is started at a rate appropriate for the vital signs.

View larger version (21K): [in this window] [in a new window]   FIGURE

This technique of jet ventilation through a nasopharyngeal airway provides optimal conditions for anesthesiology trainees to gain experience in fiberoptic assisted endotracheal intubation. To date we have experienced no complications.

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Boyce, J. R. Search for Related Content PubMed PubMed Citation Articles by Boyce, J. R.