Awake intubation using Pentax-airway scope combined with surface airway anesthesia in the cases of two obese patients with cervical spondylosis and the author himself

We report successful awake intubation using AWS combined with surface anesthesia of the upper airway via nebulizer. The two cases are suitable for awake intubation due to difficult airway. After inhaled lidocaine 4% and nebulized 4 ml, while giving fentanyl i. v, we performed awake intubation. As a preparatory step to the procedure described above, awake intubation was tested on the author himself with only surface anesthesia. The patients and author did not buck during intubation. The present case shows that it is possible to perform awake intubate safely with less stress with the combination of AWS and surface airway anesthesia via nebulizer.