Awake fiberoptic intubation remains the safest approach to managing the Difficult Airway. It is a difficult, multi-step procedure that can be time-consuming if not performed frequently. Primitive cough and gag reflexes can be challenging to block quickly with topical anesthetics.

Anesthetic recovery can be a critical period since neurocognitive problems such as agitation and delirium are often seen during the early recovery phase. We recently demonstrated that an α2-adrenergic agonist dexmedetomidine-induced unconsciousness and accompanying brain dynamics changes were completely and instantly reversed by the α2-adrenergic antagonist in the nonhuman primate model.

Securing a definitive airway in maxillofacial trauma is paramount yet challenging due to anatomical disruption, hemorrhage, and trismus. Conventional orotracheal or nasotracheal intubation can be contraindicated or hazardous. Submental intubation (SMI) has emerged as a effective and safe alternative to tracheostomy, providing unobstructed surgical access without the associated long-term morbidity.