Fiberoptic Intubation: An Overview and UpdateDiscussion

Abstract

SummaryFiberoptic intubation (FOI) is an effective technique for establishing airway access in patients with both anticipated and unanticipated difficult airways. First described in the late 1960s, this approach can facilitate airway management in a variety of clinical scenarios given proper patient preparation and technique. This paper seeks to review the pertinent technology, clinical techniques, and indications for and complications of its use. The role of FOI in airway management algorithms is discussed. Evidence is presented comparing FOI to other techniques with regard to difficult airway management. In addition, we have reviewed the literature on training processes and skill development in FOI.

Fibreoptic vs videolaryngoscopic (C-MAC®D-BLADE) nasal awake intubation under local anaesthesia

“…Some case reports also describe the successful use of these tools under sedation with preserved spontaneous breathing [8][9][10][11][12][13]. However, the standard -and up to now, probably safest -technique for the management of an anticipated difficult intubation is with a bronchoscope under local anaesthesia and mild sedation [14,15].…”

Clinical application of a novel endoscopic mask: a randomized controlled, multi-center trial in patients undergoing awake fiberoptic bronchoscopic intubation

“…However, primary complications during fiberoptic bronchoscopic tracheal intubation, such as epistaxis, laryngeal trauma, laryngospasm, aspiration, respiratory depression, etc., still trouble doctors and patients [1, 2]. Many kinds of agents are used for decreasing discomfort of patients during awake fiberoptic intubation, including propofol, dexmedetomidine, midazolam, diazepam, meperidine, remifentanil, fentanyl [3–5].…”

A Study to Compare Efficacy of Two Different Doses of Dexmedetomidine during Awake Nasotracheal Fibreoptic Intubation in Patients with Difficult Airway

“…[1] The management of a difficult airway is one of the most challenging task for an anaesthesiologist and fibreoptic intubation is an effective and reliable tool to manage such patients. [2,3] The flexible fibreoptic bronchoscope (FOB) is the most widely used, versatile, indirect laryngoscopy device, which helps in gaining access to difficult airway in routine as well as in an emergency. [3] Awake fibreoptic intubation (AFOI) is indicated in a variety of clinical situations.…”