[Newly developed BONFILS Retromolar Intubation Fiberscope for difficult airway].
Department of Anesthesiology, Saitama Medical Center, Saitama Medical School, Kawagoe 350-8550.Masui. The Japanese journal of anesthesiology 05/2006; 55(4):494-8.
Battery powered BONFILS Retromolar Intubation Fiberscope (BRIF) is a nonflexible fiberscope having the same curvature as the Macintosh laryngoscope for difficult airway. We used this device in two patients; A 65-year-old man with small chin and a 35-year-old man with neck spinal cord injury. Two trials of orotracheal intubation were accomplished easily in 20 seconds. We conclude that BRIF is useful for orotracheal intubation in patients in whom neck extension is contra-indicated.
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ABSTRACT: Background and objective Anaesthesiologists are regularly faced with difficult tracheal intubation. The objective of the study was to evaluate the feasibility and tolerability of tracheal intubation with the Bonfils intubating fibrescope in awake adult patients with predicted difficult intubation undergoing cancer surgery in an ear, nose and throat unit. Methods Intubation was performed under local anaesthesia and remifentanil sedation with spontaneous ventilation. The primary endpoint was the proportion of intubations which met the following quality requirements: successful intubation (<= 2 attempts and duration < 180 s) and good tolerability (Fahey scale < 2). Secondary endpoints included the operational problems encountered and patients' perception of the procedure immediately and 7 days after the intervention. Using a one-stage Fleming design, 32 patients were required to complete the study. Forty-one eligible adult patients were enrolled. Results Between February 2008 and March 2009, the primary endpoint could be evaluated in 33 patients. Quality requirements were met in 26 patients (78.8%) and not met in seven patients (five were intubated with the Bonfils fibrescope and two using another technique). Difficulties were reported in 13 patients (39.4%). Eighty-four percent of the patients had a good or very good perception of the intubation shortly after the procedure, and 91% after 7 days. Conclusion Tracheal intubation using the Bonfils intubating fibrescope was successful in almost all patients (93.9%). The 78.8% incidence of interventions which met the quality requirements is high in the context of ear, nose and throat cancer and acceptable in current clinical practice. In ear, nose and throat cancer patients who do not require nasopharyngeal intubation and in whom orotracheal intubation is predicted to be difficult, the use of the Bonfils intubating fibrescope is safe, effective and well tolerated.
Chapter: The Role of Optical Stylets[Show abstract] [Hide abstract]
ABSTRACT: Optical stylets are versatile airway tools now offered in many different designs that are useful for placing endotracheal tubes (ETTs) and confirming location, either used independently, with laryngoscopes, or with supraglottic airways (SGAs). There are wide variations in optical stylet length, malleability, and light sources. Their only common feature is that they provide imaging through an ETT. As they are passed beyond the vocal cords they all permit tracheoscopy.
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