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It can, however, be performed in the awake patient with local or topical anesthesia or in an emergency without any anesthesia at all. Intubation is normally facilitated by using a conventional laryngoscope , flexible fiberoptic bronchoscope , or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea ...
Most patients tolerate the procedure with only topical anesthesia of the oropharynx using lidocaine spray. However, some patients may need sedation and the very anxious/agitated patient may even need a general anesthetic. Informed consent is obtained before the procedure. The main risks are bleeding and perforation.
Adolf Kussmaul was fascinated by sword swallowers who would insert a sword down their throat without gagging. This drew inspiration to insert a hollow tube for observation; the next problem to solve was how to shine light through the tube, as they were still relying on candles and oil lamps as light sources.
Anatomical parts seen during laryngoscopy. Direct laryngoscopy is carried out (usually) with the patient lying on their back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior or posterior to the epiglottis and then lifted with an upwards ...
A laryngeal mask is composed of an airway tube that connects to an elliptical mask with a cuff which is inserted through the patient's mouth, down the windpipe, and once deployed forms an airtight seal on top the glottis (unlike tracheal tubes which pass through the glottis) allowing a secure airway to be managed by a health care provider.
Before inserting the probe, mild to moderate sedation is induced in the patient to ease the discomfort and to decrease the gag reflex. Usually a local anesthetic spray (e.g., lidocaine, benzocaine, xylocaine) is used for the back of the throat or as a jelly/lubricant anesthetic for the esophagus. Sedation and anesthesia are required to make the ...
The most common acute complications are bleeding, tracheal cartilage laceration, tracheal perforation, infection, subglottic stenosis, and voice changes. The procedure is frequently performed by an otorhinolaryngologist (an ear, nose, and throat surgeon) if available or an anesthesiologist. [21] [22]
In 1000, Abu al-Qasim al-Zahrawi (936–1013), an Arab who lived in Arabic Spain, published the 30-volume Kitab al-Tasrif, the first illustrated work on surgery. He never performed a tracheotomy, but he did treat a slave girl who had cut her own throat in a suicide attempt.