Laryngoscope-Assisted Fiberoptic Intubation in General Anesthesia - A report of 2 cases -

Abstract

Fiberoptic intubation is an important method of tracheal intubation, especially in patients with difficult airway. As fiberoptic bronchoscopy relies on clear airspace ahead of the fiberscope tip, increasing airway obstruction may cause increasing difficulty. A clear airway that allows the passage of the fiberscope is usually present in awake patients, whereas in anesthetized patients the airspace in the oropharynx is reduced; the soft palate, base of tongue and epiglottis may be applied to the posterior pharyngeal wall due to the reduction in muscle tone. Hence, fiberoptic intubation may be difficult in anesthetized patients, and maneuvers to open the airway may be required. We report a simple and useful two-person intubation technique that uses the fiberoptic bronchoscope and conventional laryngoscope, which facilitated tracheal intubation in patients who had unanticipated difficult intubation.