Abstract
BackgroundThere are many factors affecting the success rate of awake orotracheal intubation via fiberoptic bronchoscope. We performed this study was to investigate the effects of head positions on awake Fiberoptic bronchoscope oral intubation.MethodsSeventy-five adult patients, received general anaesthesia were included in this study. After written informed consent, these patients were undergoing awake orotracheal intubation via fiberoptic-bronchoscope and according to the head position, the patients were randomized allocated to neutral position group (NP group), sniffing position group (SP group) or extension position group (EP group). After sedation the patients were intubated by an experienced anesthesiologist. The time to view the vocal cords, the percentage of glottic opening scores (POGO), the time to insert the tracheal tube into trachea and the visual analog scale (VAS) scores for ease experienced of passing the tracheal tube through glottis, the hemodynamic changes and the adverse events after surgery were recorded.ResultsThe time to view the vocal cords was significantly shorter and the POGO scores was significantly higher in the EP group compared with the other two groups (P < 0.05); The SpO2 in the EP group was higher than NP group at before intubation and higher than SP group and NP group at immediate after intubation (P < 0.05); The time to insert the tracheal tube into trachea, the VAS scores for passing the tracheal tube through glottis, the coughing scores had no significant differences among groups (P > 0.05). There were also no significant differences regard to the incidence of postoperative complications, mean arterial pressure and heart rate among the groups (P > 0.05).ConclusionsThe head at extension position had a best view of glottic opening than neutral position or sniffing position during awake Fiberoptic bronchoscope oral intubation, so extension position was recommended as the starting head position for awake Fiberoptic bronchoscope oral intubation.Trial registrationClinical Trials.gov. no. NCT02792855. Registered at https://register.clinicaltrials.gov on 23 september 2017.
Highlights
There are many factors affecting the success rate of awake orotracheal intubation via fiberoptic bronchoscope
Exclusion criteria were as follows: age > 70 or < 18 years, with cervical spine disease, loose or missing incisors, preoperative hoarseness, bronchial asthma, a history of airway hyperreactivity, hypertension and abnormalities of heart, brain, liver, lung, kidney and coagulation functions. All these patients were screened by the same senior anaesthesiologist preoperatively and according to the head position, the patients were randomized allocated to neutral position group (NP group: with the occiput close to the operating table, Fig. 1A), sniffing position group (SP group: with a 7-cm pillow underneath the occiput, Fig. 1B) or extension position group
Dexmedetomidine was administered at a loading dose of 1 μg·kg− 1 remifentanil was given at a loading dose of 0.5 μg·kg− 1, followed by a continuous infusion at a speed of 0.1–0.15 μg·kg− 1·min− 1
Summary
There are many factors affecting the success rate of awake orotracheal intubation via fiberoptic bronchoscope. We performed this study was to investigate the effects of head positions on awake Fiberoptic bronchoscope oral intubation. Awake tracheal intubation via Fiberoptic bronchoscope (FOB) is regarded as the golden standard for the management of difficult airway [3,4,5,6]. Several studies have examined the effects of different methods such as jaw thrust, lingual traction or head tilt on FOB intubation [9,10,11,12,13,14,15]. There have been no study to determine which head position (neutral position, sniffing position or extension position) is the most suitable for Awake Fiberoptic bronchoscope oral intubation (AFOI). The objective of this study was to investigate the effects of three head positions during AFOI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
