Receptive music therapy with Raga Hamsadhwani for anxiolysis and ease of awake fiberoptic intubation: a case series

: Providing sedation during procedures plays an important role in improving clinical outcomes by producing anxiolysis. Some patients presenting with a difficult airway due to reduced mouth opening caused by temporomandibular joint ankylosis, oral tumours, and submucous fibrosis require general anesthesia for surgery. However, since these patients have an anticipated difficult airway, they require an awake fibreoptic intubation before general anesthesia can be administered. Managing an awake fibreoptic intubation is challenging since a fine balance between patient comfort and safety has to be maintained. Ideal sedation should ensure good patient comfort, smooth intubating conditions, and stable hemodynamic parameters without respiratory depression. Receptive music therapy is an innovative technique that may be used during awake procedures to improve patient comfort and reduce their anxiety. However, it has never been used to provide patient cooperation and comfort during awake fibreoptic intubations. We used an instrumental version of Indian Raga Hamsadhwani in five cases of anticipated difficult airway to provide sedation during awake fibreoptic intubation. We report comfortable, cooperative and sedated patients with successful first attempt intubations in all of them.