Kinking of Disposable Fiberoptic Bronchoscope During Difficult Nasal Awake Intubation

Cyrus Motamed,Mohamed Abdellaoui,Lauriane Bordenave

doi:10.31487/j.gccr.2019.01.03

Abstract

Background: disposable fiberoptic for intubation are more and more available in operating room We hereby report a complication of a difficult fiberoptic intubation performed with a disposable fiberscope. Case: Under remifentanil sedation Visualizing the glottis was easy while advancing the endotracheal tube through the fiberscope was mildly difficult. Removing the fiberscope was impossible as was the removal of the endotracheal tube. The patient was becoming uncomfortable. Under local anesthesia we performed a jet ventilation after puncture of the cricothyroid membrane followed by total intravenous anesthesia. A cervicofacial surgeon visualized the kinking of the fiberscope at the tip of the endotracheal tube. The fiberscope was removed under direct vision with a rigid bronchoscope. Conclusion: Because of more flexibility disposable fiberscopes may kink during the introduction of the endotracheal tube.

Highlights

Background: disposable fiberoptic for intubation are more and more available in operating room We hereby report a complication of a difficult fiberoptic intubation performed with a disposable fiberscope
During the anesthetic assessment a probable difficult intubation was predicted mainly because of the size of the free flap and the closure of the tracheotomy, an awake fiberoptic intubation was decided for management of difficult airway
Locating the glottis was mildly difficult probably because of the swelling of the free flap in the oropharynx, the fiberscope could pass the glottis after local anesthesia injected through the fibroscope

Summary

Introduction

Background: disposable fiberoptic for intubation are more and more available in operating room We hereby report a complication of a difficult fiberoptic intubation performed with a disposable fiberscope. Kinking of Disposable Fiberoptic Bronchoscope During Difficult Nasal Awake Intubation Case: Under remifentanil sedation Visualizing the glottis was easy while advancing the endotracheal tube through the fiberscope was mildly difficult.

Results

Conclusion