| Teaching the use of fiberoptic intubation in anesthetized, spontaneously breathing patients. | |
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MedLine Citation:
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PMID: 10553854 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In patients with difficult airways, the standard of care involves fiberoptic intubation under spontaneous ventilation. However, the safety and feasibility of a fiberoptic intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal fiberoptic intubation. Five anesthesia residents with no prior experience in fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful intubation of the trachea within two attempts, was not different between groups. During fiberoptic intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to <95% in two patients in Group B. Failure to pass the tube into the trachea over the bronchoscope was encountered in four patients in Group A and in no patient in Group B. Our data suggest that it is safe to teach the use of fiberoptic intubation in anesthetized, spontaneously breathing patients with normal airway anatomy. IMPLICATIONS: Fiberoptic intubation under spontaneous respiration is a well established technique for management of difficult airways. Our study demonstrates the feasibility and safety of a novice training program for fiberoptic intubation under general anesthesia, not only in paralyzed patients but also in those breathing spontaneously. |
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Authors:
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T Erb; K F Hampl; M Schürch; C G Kern; S C Marsch |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 89 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1999 Nov |
Date Detail:
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Created Date: 1999-11-19 Completed Date: 1999-11-19 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1292-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia, University of Basel/Kantonsspital, Switzerland. ERB00003@mc.duke.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia, General* Anesthesia, Intravenous Anesthesiology / education* Anesthetics, Inhalation Female Fiber Optic Technology Humans Internship and Residency* Intubation, Intratracheal* Male Methyl Ethers Neuromuscular Blockade Respiration |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane |
| Comments/Corrections | |
Comment In:
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Anesth Analg. 2000 Oct;91(4):1044
[PMID:
11004086
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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