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Year 2023, Volume: 3 Issue: 1, 35 - 41, 08.01.2023

Abstract

References

  • American Society of Anesthesiologists Task Force on Management of the Difficult Airway Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269- 77.
  • George E, Haspel KL. The difficult airway. Int Anesthesiol Clin. 2000;38(3):47-63. doi: 10.1097/00004311-200007000-00005.
  • Ajay S, Singhania A, Akkara AG, Shah A, Adalja M. A study of flexible fiberoptic bronchoscopy aided tracheal intubation for patients undergoing elective surgery under general anesthesia. Indian J Otolaryngol Head Neck Surg. 2013;65(2):116-9. doi: 10.1007/s12070-012-0576-8.
  • https://www.uptodate.com/contents/image?image Key=EM%2F75229 (Last accessed date: 02/12/2022).
  • Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487-90. doi: 10.1111/j.1365-2044.1987. tb04039.x.
  • Rodrigues AJ, Scordamaglio PR, Palomino AM, Oliveira EQ, Jacomelli M, Figueiredo VR. Difficult airway intubation with flexible bronchoscope. Braz J Anesthesiol. 2013;63(4):358-61. doi: 10.1016/j.bjane.2012.05.001.
  • Lim WY, Wong P. Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: A case series and narrative review. Korean J Anesthesiol. 2019;72(6):548-57. doi: 10.4097/kja.19318.
  • Abdellatif AA, Ali MA. GlideScope videolaryngoscope versus flexible fiberoptic bronchoscope for awake intubation of morbidly obese patient with predicted difficult intubation. Middle East J Anaesthesiol. 2014;22(4):385-92.
  • Gómez-Ríos MÁ. Can fiberoptic bronchoscopy be replaced by video laryngoscopy in the management of difficult airway? Rev Esp Anestesiol Reanim. 2016;63(4):189-91. doi: 10.1016/j.redar.2015.11.008.
  • Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW. Management of the difficult airway: A closed claims analysis. Anesthesiology. 2005;103(1):33-9. doi:10.1097/00000542-200507000- 00009

Tracheal intubation is not difficult with flexible bronchoscopy guidance

Year 2023, Volume: 3 Issue: 1, 35 - 41, 08.01.2023

Abstract

We aimed to evaluate the efficacy and safety of flexible bronchoscopy-guided tracheal intubation during difficult airways. We retrospectively evaluated the hospital records of intubated patients with the assistance of a flexible bronchoscope during 5 years-period, (between January 2015 to 2020). All patients were intubated under general anesthesia. A total of 67 patients were enrolled in the study. The majority of the patients were male (n=42, 62.7%). The mean age was 55.5±15.3 years. Mallampati classification was revealed frequently in class IV in 76.1% of cases. Only one patient with class II is evaluated as having a difficult airway because of obesity. The most frequent 3 indications for endotracheal tube (ETT) insertion (intubation) with the help of a bronchoscope were limitation of the mouth opening (40.3%), obesity (20.9%), and cervical-vertebrate fracture (11.9%). The intubation route was preferred as the oral way in 53 patients and the nasal way in 14 patients. The mean duration for ETT intubation via bronchoscopy guidance was 3.38 minutes. There was no severe complication other than transient oxygen desaturation (SaO2) below 90% (n=8, 11.9%) and epistaxis (n=2, 3%) in the complication records of all patients. Intubation with the help of a flexible bronchoscope is an effective, practical, and safe method in patients with a difficult airway.

References

  • American Society of Anesthesiologists Task Force on Management of the Difficult Airway Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269- 77.
  • George E, Haspel KL. The difficult airway. Int Anesthesiol Clin. 2000;38(3):47-63. doi: 10.1097/00004311-200007000-00005.
  • Ajay S, Singhania A, Akkara AG, Shah A, Adalja M. A study of flexible fiberoptic bronchoscopy aided tracheal intubation for patients undergoing elective surgery under general anesthesia. Indian J Otolaryngol Head Neck Surg. 2013;65(2):116-9. doi: 10.1007/s12070-012-0576-8.
  • https://www.uptodate.com/contents/image?image Key=EM%2F75229 (Last accessed date: 02/12/2022).
  • Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487-90. doi: 10.1111/j.1365-2044.1987. tb04039.x.
  • Rodrigues AJ, Scordamaglio PR, Palomino AM, Oliveira EQ, Jacomelli M, Figueiredo VR. Difficult airway intubation with flexible bronchoscope. Braz J Anesthesiol. 2013;63(4):358-61. doi: 10.1016/j.bjane.2012.05.001.
  • Lim WY, Wong P. Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: A case series and narrative review. Korean J Anesthesiol. 2019;72(6):548-57. doi: 10.4097/kja.19318.
  • Abdellatif AA, Ali MA. GlideScope videolaryngoscope versus flexible fiberoptic bronchoscope for awake intubation of morbidly obese patient with predicted difficult intubation. Middle East J Anaesthesiol. 2014;22(4):385-92.
  • Gómez-Ríos MÁ. Can fiberoptic bronchoscopy be replaced by video laryngoscopy in the management of difficult airway? Rev Esp Anestesiol Reanim. 2016;63(4):189-91. doi: 10.1016/j.redar.2015.11.008.
  • Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW. Management of the difficult airway: A closed claims analysis. Anesthesiology. 2005;103(1):33-9. doi:10.1097/00000542-200507000- 00009
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Sibel Günay This is me 0000-0001-6085-417X

Ersin Günay This is me 0000-0002-2671-4584

Aydın Balcı This is me 0000-0002-9072-3397

İbrahim Güven Coşğun This is me 0000-0001-7365-8098

Şule Çilekar This is me 0000-0001-8659-955X

Şule Esen Karamişe4 This is me 0000-0002-1915-2771

Feyza Merve Sekkin Sınıcı This is me 0000-0002-2657-7874

Remziye Gül Sıvacı This is me

Publication Date January 8, 2023
Published in Issue Year 2023 Volume: 3 Issue: 1

Cite

Vancouver Günay S, Günay E, Balcı A, Coşğun İG, Çilekar Ş, Esen Karamişe4 Ş, Sekkin Sınıcı FM, Sıvacı RG. Tracheal intubation is not difficult with flexible bronchoscopy guidance. Health Sci. Q. 2023;3(1):35-41.