Efficiency of a new fiberoptic stylet scope in tracheal intubation.
ABSTRACT Failed or difficult tracheal intubation is an important cause of morbidity and mortality during anesthesia. Although a number of fiberoptic devices are available to circumvent this problem, many do not allow manual control of the flexion of the tip and necessitate time-consuming preparation, special training, or the use of an external light source. To improve these limitations, the authors designed a new fiberoptic stylet scope (FSS) that has a simple form of a standard stylet with the fiberoptic view and maneuverability of its tip. This study was undertaken to prospectively evaluate the effectiveness of the FSS in tracheal intubation.
Thirty-two patients undergoing general surgery participated in this study. The authors used a standard laryngoscope only to elevate the tongue, then tracheal intubation was attempted with the glottic opening being viewed only through the FSS. The success rate, time necessary for intubation, hemodynamics, and adverse effects were recorded.
The success rate of tracheal intubation on the first attempt using the FSS was 94% (30 of 32 patients), and the remaining two patients were intubated successfully on the second attempt. The mean time necessary for the intubation procedure was 29+/-14 s in all patients (mean +/- SD). Changes in hemodynamics during intubation were well within acceptable ranges. There were no major adverse effects, but minor sore throat (28%) and minor hoarseness (25%) on the first postoperative day.
Tracheal intubation using the FSS proved to be a simple and effective technique for airway management.
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ABSTRACT: This is a retrospective study of patients whose tracheas were impossible to intubate on a previous occasion. There is a correlation between the degree of difficulty and the anatomy of the oropharynx in the same patient. The study was initially on obstetric patients but was extended to nonobstetric surgical patients in order to increase the number of cases investigated. The incidence of failed intubations in the obstetric group over a 3-year period was seven out of 1980 cases, whereas in the surgical group the results were six out of 13,380 patients. Any screening test which adds to our ability to predict difficulty in intubation must be welcomed, as failure to intubate can potentially lead to fatality.Anaesthesia 06/1987; 42(5):487-90. · 3.49 Impact Factor
- Anaesthesia 10/1989; 44(9):791. · 3.49 Impact Factor
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ABSTRACT: Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will not meet the problem in their first few years and may thus be unprepared for it in obstetrics. However the problem can be simulated in routine anaesthesia, so that a drill for managing it can be practised. Laryngoscopy is carried out as usual, then the blade is lowered so that the epiglottis descends and hides the cords. Intubation has to be done blind, using the Macintosh method. This can be helpful as part of the training before starting in the maternity department, supplementing the Aberdeen drill.Anaesthesia 12/1984; 39(11):1105-11. · 3.49 Impact Factor