How does local anesthetic airway topicalisation, for awake fiberbreoptic intubation (AFOI), affect patient reaction time?

The Psychometric effect of topical lignocaine on healthy volunteers in an awake fibre optic course, tested by complex reaction time and balance and related to plasma lignocaine levels.

Status

Not yet recruiting

Phases

Phase 4

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12610000459022

Enrollment

Registered

2010-06-04

Start date

2010-06-19

Completion date

Unknown

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Awake fibreoptic intubation (AFOI) is the method of choice for intubation and securing of a potentially difficult airway. Routine practice worldwide involves ‘topicalisation’ (numbing) of the airway with Local Anaesthetic (LA) to enable a fiber optic camera to be advanced through the airway and into the trachea, usually with the patient awake and under no sedative influence. Currently there are no data on the effects of the LA used this way on cognitive or motor function, and patients are allowed to return home shortly after such a procedure. There is no advice given with regards to driving or operating heavy machinery despite anesthetists who have had this procedure describing ‘funny feelings’ following administration of topical LA and multiple studies that report subjective feeelings of dizzines, tingling, euphoria and dysphoria We wish to assess the impact of LA on reaction time (and hence both neural and motor function) following volunteer participation in an AFOI Course that we run half yearly for anesthetists

Interventions

Lignocaine topicalization for awke fibre optic intubation. a)"Spray as you Go" topicalization with Micro Atomizer Device (MAD) b)Dose titrated to comfort with instumentation. (Difference in dose noted and related to Psychometric effects and plasma levels.) c)Max dose less than 9mg/kg as per safety guidelines d)Duration from start of topicalization to intubation 30 minutes on average.

Study design

Allocation

Non-randomised trial

Intervention model

Single group

Primary purpose

Educational / counselling / training

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to 60 Years

Healthy volunteers

Yes

Inclusion criteria

voluntary participants in an awake fibre optic course

Exclusion criteria

1. Known intolerance or allergy to any study drug. (Lidocaine) 2. Active psychosis or history of schizophrenia 3. Pregnancy 4. Severe heart disease, liver disease, diabetes or asthma. 5. Epilepsy 6. History of epistaxis or nasal problems

Outcome results