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

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: The use of course delegates as subjects for training was acceptable to anaesthetists and is associated with a low level of discomfort and morbidity.