Editing Tracheal intubation (section)

==Alternatives==
Although it offers the greatest degree of protection against regurgitation and pulmonary aspiration, tracheal intubation is not the only means to maintain a patent airway. Alternative techniques for airway management and delivery of oxygen, volatile anesthetics or other [[breathing gas]]es include the [[laryngeal mask airway]], i-gel, cuffed oropharyngeal airway, [[positive airway pressure|continuous positive airway pressure]] (CPAP mask), nasal [[Positive airway pressure#Bi-level pressure devices|BiPAP]] mask, simple face mask, and nasal cannula.<ref name=McGee2007/>

General anesthesia is often administered without tracheal intubation in selected cases where the procedure is brief in duration, or procedures where the depth of anesthesia is not sufficient to cause significant compromise in ventilatory function. Even for longer duration or more invasive procedures, a general anesthetic may be administered without intubating the trachea, provided that patients are carefully selected, and the [[Risk-benefit analysis|risk-benefit ratio]] is favorable (i.e., the risks associated with an unprotected airway are believed to be less than the risks of intubating the trachea).<ref name=McGee2007/>

Airway management can be classified into closed or open techniques depending on the system of ventilation used. Tracheal intubation is a typical example of a closed technique as ventilation occurs using a closed circuit. Several open techniques exist, such as spontaneous ventilation, apnoeic ventilation or jet ventilation. Each has its own specific advantages and disadvantages which determine when it should be used.

Spontaneous ventilation has been traditionally performed with an inhalational agent (i.e. gas induction or inhalational induction using halothane or sevoflurane) however it can also be performed using intravenous anaesthesia (e.g. propofol, ketamine or dexmedetomidine). SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) is an open airway technique that uses an upwards titration of propofol which maintains ventilation at deep levels of anaesthesia. It has been used in airway surgery as an alternative to tracheal intubation.<ref>{{Cite journal|last1=Booth|first1=A. W. G.|last2=Vidhani|first2=K.|last3=Lee|first3=P. K.|last4=Thomsett|first4=C.-M.|date=2017-03-01|title=SponTaneous Respiration using IntraVEnous anaesthesia and Hi-flow nasal oxygen (STRIVE Hi) maintains oxygenation and airway patency during management of the obstructed airway: an observational study|url= |journal=British Journal of Anaesthesia|volume=118|issue=3|pages=444–451|doi=10.1093/bja/aew468|pmid=28203745|pmc=5409133|issn=0007-0912}}</ref>