Korean J Anesthesiol.  2010 Mar;58(3):249-255. 10.4097/kjae.2010.58.3.249.

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

• Kim SH
• Woo SJ
• Kim JH

• KMID: 1854024
• DOI: http://doi.org/10.4097/kjae.2010.58.3.249

Abstract

BACKGROUND
To 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. METHODS: In 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 (T(total)) 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. RESULTS: T1, T2, and T(total) 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. CONCLUSIONS: Intubation of difficult airways can be performed more rapidly with BIF-DL, but sometimes it may not be possible to intubate with the scope.

Keyword

Bronchoscopes; Fiberoptics; Intubation; Laryngoscopy; Video recording

MeSH Terms

Anesthesia, General
Bronchoscopes
Bronchoscopy
Hoarseness
Humans
Hypogonadism
Incidence
Intubation
Laryngoscopy
Mitochondrial Diseases
Ophthalmoplegia
Pharyngitis
Video Recording
Vocal Cords
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia