Technics for Fiberoptic Laryngoscopy in Anesthesia

Comparison of Two Methods of Fibrescope-Guided Tracheal Intubation

“…Arterial pressure and heart rate were measured at 1-min intervals using a recently calibrated Dinamap 1846 oscillotonometer and recorded with a Dinamap TR2000 printer. After a stabilization period of at least 5 min, baseline recordings were taken and anaesthesia was induced with a dose of thiopentone sufficient to obtund the eyelash reflex (usually 5 mg kg" 1 ), followed by vecuronium 0.125 mg kg" 1 . The patient's lungs were ventilated with 1 % isoflurane and 50% nitrous oxide in oxygen using a Bain system and face mask with an initial fresh gas flow of 90 ml kg" 1 min" 1 .…”

“…After a stabilization period of at least 5 min, baseline recordings were taken and anaesthesia was induced with a dose of thiopentone sufficient to obtund the eyelash reflex (usually 5 mg kg" 1 ), followed by vecuronium 0.125 mg kg" 1 . The patient's lungs were ventilated with 1 % isoflurane and 50% nitrous oxide in oxygen using a Bain system and face mask with an initial fresh gas flow of 90 ml kg" 1 min" 1 . A Datex Normocap capnometer sampling catheter was placed under the face mask and fresh gas flow rate and ventilation were adjusted to maintain the endexpired carbon dioxide concentration at 4.5-5 %.…”

“…The fibreoptic laryngoscope may permit tracheal intubation, often with ease, in awake or anaesthetized patients, when traditional methods have failed [1,2]. However, it has been shown that fibrescope-guided orotracheal intubation facilitated by anterior traction on the tongue under general anaesthesia requires a prolonged intubation time and produces greater pressor and heart rate changes than intubation with the Macintosh laryngoscope [3].…”

Fibreoptics in Anaesthesia and Intensive Care

“…The procedure could also be performed in children 'with equal ease and rapidity' 12 . Although some viewed this as the dawn of a 'new era' 14 for difficult airway management, others cautioned that the cost of such equipment might preclude its use in low-resource settings 10 . Flexible fibreoptic bronchoscopes were subsequently utilised to confirm the position of double-lumen endobronchial tubes in thoracic anaesthesia 15 and in various diagnostic and therapeutic procedures in intensive care.…”

“…During the early 1970s, proprietary fibreoptic bronchoscopes 10,11 , as well as purpose-made, flexible fibreoptic laryngoscopes [12][13][14] , began to be used widely for endotracheal intubation in both awake and anaesthetised patients. Reporting a series of 100 patients, including 34 with severe anatomical abnormalities, Catherine Stiles and colleagues from the University of Southern California…”