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

Background. We describe a practical method of training anaesthetistsin the technique of awake fibreoptic intubation. This is performedon a training course using the delegates as subjects. Methods. The first 15 subjects underwent cardiovascular monitoringduring airway fibreoptic endoscopy performed by other coursemembers. They were subsequently interrogated by use of a questionnaire. Results. Evidence from questionnaires suggests this method ofinstruction 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-fourper cent of subjects found the procedure slightly painful; 46%reported no pain at all. Overall, the procedure was rated asacceptable by 85% of subjects and enjoyable by 15% of subjects.No delegate found endoscopy or intubation distressing. Cardiovascularmonitoring revealed pulse rate and arterial pressure changesof less than 25% of baseline values. Paraesthesia developedin one individual and nasal bleeding in two cases, neither ofwhich was clinically significant and did not interfere withendoscopy. Conclusions. The use of course delegates as subjects for trainingwas acceptable to anaesthetists and is associated with a lowlevel of discomfort and morbidity. Br J Anaesth 2002; 89: 586–93