A comparison of direct laryngoscopy and jaw thrust to aid fibreoptic intubation*

Stacey, M.; Rassam, S.; Sivasankar, Rajeev; Hall, Judith Elizabeth; Latto, I. P.

doi:10.1111/j.1365-2044.2004.04119.x

Cited by 37 publications

(56 citation statements)

References 22 publications

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“…However, our endpoint allowed a crossover design and so increased the overall power of our study, and we were particularly interested in the degree to which the two techniques would result in airway clearance, which we felt was best assessed by the ease with which the vocal cords could be viewed. Dugra et al devised a subjective scoring system to describe the degree of obstruction of view during fibrescopy [8] and this scale was also used by Stacey et al [9]. We chose not to use a subjective scale, as we felt that poor views should be reflected in a longer time (or failure) to view the vocal , pages 1048-1052 .…”

Section: Discussionmentioning

confidence: 99%

A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal intubation*

Iqbal¹,

Gardner‐Thorpe²,

Thompson

et al. 2006

Anaesthesia

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SummaryThis study compared the efficacy of an anterior jaw lift manoeuvre with that of the Berman airway in clearing the upper airway during oral fibreoptic tracheal intubation in anaesthetised, paralysed patients. Fifty patients were randomly assigned to undergo fibreoptic-assisted intubation with one method, followed by crossover to the alternative method. The time taken to view the vocal cords was the primary endpoint, and we also noted the rate of failure to view the cords, i.e. cords not seen after 120 s of endoscopy. Anterior jaw lift yielded significantly shorter times to view the vocal cords (median [interquartile range; range]: 22 [17-46; 7-120] s vs 40 [29-67; 21-120] s, p = 0.001) and a higher success rate (49 ⁄ 50 vs 42 ⁄ 50, p = 0.014). We conclude that the anterior jaw lift is more effective than the Berman device for achieving airway clearance in this setting.

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Section: Discussionmentioning

confidence: 99%

A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal intubation*

Iqbal¹,

Gardner‐Thorpe²,

Thompson

et al. 2006

Anaesthesia

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show abstract

“…Previous studies [4,12] suggest that the jaw-thrust manoeuvre provides a clear view at the epiglottis but not at the soft palate level. When lingual traction was combined with jaw thrust, the airway was cleared at both the soft palate and epiglottic levels in all patients [4].…”

Section: Discussionmentioning

confidence: 99%

“…However, lingual traction can injure the tongue tissue. Moreover, Stacey et al [12] compared two manoeuvres, jaw thrust and direct laryngoscopy, to open the airway during fibreoptic intubation, and showed that direct laryngoscopy provided significantly better airway clearance at the level of the soft palate than did jaw thrust, although airway clearance was equally good at the epiglottis level. However, laryngoscopic assistance can increase cardiovascular responses [13], and is difficult to use in patients with cervical spine abnormalities or weak teeth.…”

Section: Discussionmentioning

confidence: 99%

Effects of the jaw‐thrust manoeuvre in the semi‐sitting position on securing a clear airway during fibreoptic intubation

et al. 2015

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SummarySecuring a clear airway is important for successful fibreoptic intubation. We investigated whether the jaw-thrust manoeuvre in the 25°semi-sitting position improves airway clearance compared with the supine position in 88 anaesthetised patients randomly assigned to the two positions. After induction of anaesthesia, the fibreoptic bronchoscope was advanced into the mouth along the dorsum of the tongue during the jaw-thrust manoeuvre. Airway clearance was assessed at the level of the soft palate and epiglottis. Patients in the 25°semi-sitting position had clearer airways (judged subjectively by a three-level scale) than those in the supine position at the soft palate level (p = 0.012). At the level of the epiglottis, airway clearance was equally good in both positions. The mean (SD) times to view the vocal cord and carina were shorter in the 25°semi-sitting position (4 (1) s and 8 (1) s, respectively) compared with the supine position (6 (3) s and 11 (3) s; p < 0.001, respectively). The time to achieve intubation was also shorter in the 25°semi-sitting position (21 (5) s) than in the supine position (25 (7) s; p = 0.018).

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“…In addition, BIF requires a short preparation time and it can be used quickly in an emergency situation [11]. Although intubation can be done using an FOB or BIF without any assisting device, even in difficult airways, there have been several studies that the difficult intubation can be facilitated by direct laryngoscopy (DL) [11-13]. Accordingly, it might be preferable to perform intubation using FOB or BIF assisted by direct laryngoscopy in difficult intubation patients.…”

Section: Introductionmentioning

confidence: 99%

A comparison of Bonfils intubation fiberscopy and fiberoptic bronchoscopy in difficult airways assisted with direct laryngoscopy

Kim

Woo

Kim

2010

Korean J Anesthesiol

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BackgroundTo evaluate the usefulness of Bonfils intubation fiberscope assisted by direct laryngoscopy (BIF-DL) and flexible fiberoptic bronchoscope assisted by direct laryngoscopy (FOB-DL) using video recording in cases of unanticipated difficult intubation with respect to the time required to visualize the vocal cords and place the endotracheal tube. We compared two fiberscopes in patients with authentic difficult airways.MethodsIn this randomized, controlled clinical trial, 40 patients (grade 3 according to grades of difficulty in laryngoscopy), scheduled for surgery under general anesthesia were randomly allocated to BIF-DL group or FOB-DL group. Number of attempts, time required for visualization of the vocal cord (T1) and placement of the endotracheal tube (T2) from insertion of instrument during the last successful attempt, and duration of scope manipulation during all attempts (Ttotal) were recorded. If intubation failed with one method, the other method was tried; these cases were then excluded. The incidence of sore throat and hoarseness was assessed.ResultsT1, T2, and Ttotal were significantly shorter in BIF-DL group (T1: 21.9 ± 8.2 sec vs. 80.4 ± 29.9 sec, P < 0.001, Ttotal: 77.9 ± 41.2 sec vs. 145.5 ± 83.9 sec, P = 0.003). In two cases, it was impossible to intubate with BIF-DL, but the procedure was subsequently successful using fibreoptic bronchoscope.ConclusionsIntubation of difficult airways can be performed more rapidly with BIF-DL, but sometimes it may not be possible to intubate with the scope.

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A comparison of direct laryngoscopy and jaw thrust to aid fibreoptic intubation*

Cited by 37 publications

References 22 publications

A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal intubation*

A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal intubation*

Effects of the jaw‐thrust manoeuvre in the semi‐sitting position on securing a clear airway during fibreoptic intubation

A comparison of Bonfils intubation fiberscopy and fiberoptic bronchoscopy in difficult airways assisted with direct laryngoscopy

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