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Principles of Airway Management pp 78–125Cite as

Fiberoptic Airway Management Techniques

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Summary

The development of fiberoptic endoscopic techniques and the proliferation of teaching protocols and workshops is testimony to the utility of this revolutionary airway management intervention. To gain proficiency

  1. 1.

    Attend a workshop presented by a recognized authority and teacher in the field of fiberoptic airway management techniques.

  2. 2.

    Develop an organized and efficient training protocol in your institution.

  3. 3.

    Practice as many different fiberoptic airway techniques as possible under the guidance of a competent colleague.

  4. 4.

    Use the fiberoptic endoscope on a routine basis.

  5. 5.

    Apply the techniques to pediatric as well as adult patients.

Finally, you must define your level of competence with fiberoptic airway techniques. Knowing your level will allow you to apply your skills appropriately when dealing with a difficult airway.

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References

  1. Ovassapian A. Fiberoptic Endoscopy and the Difficult Airway. 2nd ed. Philadelphia: Lippincott-Raven, 1996.

    Google Scholar 

  2. Fulling PD, Roberts, JT. Fiberoptic intubation. Inter Anesth Clin. 2000;38(3):189–217.

    Article  CAS  Google Scholar 

  3. Dierdorf SF. The physics of fiberoptic endoscopy. Mt Sinai J Med. 1995;62(1):3–9.

    CAS  PubMed  Google Scholar 

  4. Dierdorf SF. Use of the flexible fiberoptic laryngoscope. Mt Sinai J Med. 1995;62(1):21–26.

    CAS  PubMed  Google Scholar 

  5. Lefebvre DL, Stock MC. Fiberoptic glottic examination to promote safe prolonged tracheal intubation. Anesthesiology. 1988;69:A177.

    Google Scholar 

  6. Dellinger RP, Bandi V. Fiberoptic bronchoscopy in the intensive care unit. Crit Care Clin. 1992;8:755.

    CAS  PubMed  Google Scholar 

  7. Clark PT, et al. Removal of proximal and peripheral endobronchial foreign bodies with the flexible fiberoptic bronchoscope. Anaesth Intensive Care 1989;17:205–208.

    CAS  PubMed  Google Scholar 

  8. Koppel JN. Learning fiberoptic-guided endotracheal intubation. Mt Sinai J Med. 1995;62(1):41–46.

    CAS  PubMed  Google Scholar 

  9. Colley PS, Freund P. An aid to learning to use the fiberoptic bronchoscope for intubation. Anesth Analg. 1997;85:464–465.

    Article  CAS  PubMed  Google Scholar 

  10. Naik VN, et al. Fiberoptic orotracheal intubation on anesthetized patients. Anesthesiology. 2001;95(2):343–348.

    Article  CAS  PubMed  Google Scholar 

  11. Mallios C, et al. Fiberoptic cart for intubation and teaching. Can J Anaesth. 1998; 4512):1220–1221.

    CAS  PubMed  Google Scholar 

  12. Schaefer HG, et al. Teaching fiberoptic intubation in anaesthetised patients. Anaesthesia. 1994;49:331–334.

    CAS  PubMed  Google Scholar 

  13. Erb T, et al. Teaching the use of fiberoptic intubation in anesthetized, spontaneously breathing patients. Anesth Analg. 1999;89:1292–1295.

    Article  CAS  PubMed  Google Scholar 

  14. Erb T, et al. Teaching the use of fiberoptic intubation for children older than two years of age. Anesth Analg. 1997;85:1037–1041.

    Article  CAS  PubMed  Google Scholar 

  15. ASA Difficult Airway Algorithm. 2001. Available http://www.asahq.org

  16. Chung D. A modified Williams airway intubator to assist fiberoptic intubation. Can J Anaesth. 1998;45(1):95.

    CAS  PubMed  Google Scholar 

  17. Aoyama K, et al. Simple modification of the Ovassapian fiberoptic intubating airway. Anesthesiology. 1999;91(3):897.

    Article  CAS  PubMed  Google Scholar 

  18. Ravindran RS. Another advantage of marking Ovassapian fiber-optic intubating airway. Anesthesiology. 2000;92(6):1843.

    Article  CAS  PubMed  Google Scholar 

  19. Goskowicz R, et al. Fiberoptic tracheal intubation using a nipple guide. Anesthesiology. 1996;85(5):1210.

    Article  CAS  PubMed  Google Scholar 

  20. Krensavage TJ. Oral obturator a useful adjunct for fiberoptic tracheal intubation. Anesthesiology. 1996;85(4):942.

    CAS  PubMed  Google Scholar 

  21. Higgins MS, Marco AP. An aid in oral fiberoptic intubation. Anesthesiology. 1992; 77:1236.

    CAS  PubMed  Google Scholar 

  22. Frei FJ, Ummenhofer W. A special mask for teaching fiber-optic intubation in pediatric patients. Anesth Analg. 1993;76:458.

    CAS  PubMed  Google Scholar 

  23. Okuda M, et al. A new device for fiberoptic endotracheal intubation under general anesthesia. Anesthesiology. 1988;69:637.

    CAS  PubMed  Google Scholar 

  24. Magaro T, et al. Ventilation via a mouth mask facilitates fiberoptic nasal tracheal intubation in anesthetized patients. Anesthesiology. 1993;78:603.

    Google Scholar 

  25. Waring PH, Vinik HR. A potential complication of the Patil-Syracuse endoscopy mask. Anesth Analg. 1991;73:668.

    CAS  PubMed  Google Scholar 

  26. Williams L, et al. Foreign body from a Patil-Syracuse mask for fiberoptic intubation. Anesth Analg. 1991;73:359.

    CAS  PubMed  Google Scholar 

  27. Davis K. Alterations to the Patil-Syracuse mask for fiberoptic intubation. Anesth Analg. 1992;74:472.

    CAS  PubMed  Google Scholar 

  28. Barker KF, et al. Ease of laryngeal passage during fiberoptic intubation a comparison of three endotracheal tubes. Acta Anaesthesiol Scand. 2001;45:624–626.

    Article  CAS  PubMed  Google Scholar 

  29. Greer JR, et al. A comparison of tracheal tube tip design on the passage of an endotracheal tube during oral fiberoptic intubation. Anesthesiology. 2001;94(5):729–731.

    Article  Google Scholar 

  30. Greer R, et al. Comparison of two tracheal tube tip designs for oral fiberoptic intubation. Br J Anaesth. 2000;84(2):281.

    Google Scholar 

  31. Jones HE, et al. Fiberoptic intubation influence of tracheal tube tip design. Anaesthesia. 1993;48:672–674.

    CAS  PubMed  Google Scholar 

  32. Rosenblatt WH. Overcoming obstruction during bronchoscope-guided intubation of the trachea with the double setup endotracheal tube. Anesth Analg. 1996;83:175–177.

    Article  CAS  PubMed  Google Scholar 

  33. Marsh NJ. Easier fiberoptic intubations. Anesthesiology. 1992;76:860–861.

    CAS  PubMed  Google Scholar 

  34. Brull SJ, et al. Facilitation of fiberoptic orotracheal intubation with a flexible tracheal tube. Anesth Analg. 1994;78:746–748.

    CAS  PubMed  Google Scholar 

  35. Hakala P, et al. Comparison between tracheal tubes for orotracheal fiberoptic intubation. Br J Anaesth. 1999;82(1):135–136.

    CAS  PubMed  Google Scholar 

  36. Guzman JL. Use of a short flexible fiberoptic endoscope for difficult intubations. Anesthesiology. 1997;87(6):1563–1564.

    Article  CAS  PubMed  Google Scholar 

  37. Saruki N, et al. Swift conversion from laryngoscopic to fiberoptic intubation with a new, handy fiberoptic stylet. Anesth Analg. 1999;89:526–528.

    Article  CAS  PubMed  Google Scholar 

  38. Morris IR. Fibreoptic intubation. Can J Anaesth. 1994;41(10):996–1008.

    Google Scholar 

  39. Cole AR, et al. Fibreoptic intubation. Can J Anaesth. 1995;42(9):840.

    Google Scholar 

  40. Hershey MD, Hannenberg AA. Gastric distention and rupture from oxygen insufflation during fiberoptic intubation. Anesthesiology. 1996;85(6):1479–1480.

    Article  CAS  PubMed  Google Scholar 

  41. Ovassapian A, Mesnick PS. Oxygen insufflation through the fiberscope to assist intubation is not recommended. Anesthesiology. 1997;87(1):183.

    Article  CAS  PubMed  Google Scholar 

  42. Brookman CA, et al. Anticholinergics improve fiberoptic intubating conditions during general anaesthesia. Can J Anaesth. 1997;44(2):165–167.

    CAS  PubMed  Google Scholar 

  43. Ezri T, et al. Central anticholinergic syndrome complicating management of a difficult airway. Can J Anaesth. 1996;43(10):1079.

    CAS  PubMed  Google Scholar 

  44. Smith JE, Reid AP. Selecting the safest nostril for nasotracheal intubation with the fibreoptic laryngoscope. Br J Anaesthesia. 1999;82(suppl 1):26.

    Google Scholar 

  45. Balatbat JT, et al. Controlled intermittent aerosolization of lidocaine for airway anesthesia. Anesthesiology. 1999;91(2):596.

    Article  CAS  PubMed  Google Scholar 

  46. Smith T. Jetting lidocaine through the atomizer. Anesthesiology. 1999;90(2):634.

    PubMed  Google Scholar 

  47. Barclay PM, O’Sullivan E. Systemic absorption of cocaine during fibreoptic bronchoscopy. Br J Anaesth. 1999;83:518P–519P.

    Google Scholar 

  48. Khorasani A, et al. Canister tip orientation and residual volume have significant impact on the dose of benzocaine delivered by Hurricaine spray. Anesth Analg. 2001;92:379–383.

    Article  CAS  PubMed  Google Scholar 

  49. Ellis FD, et al. Methemoglobinemia: a complication after fiberoptic orotracheal intubation with benzocaine spray. J Bone Joint Surg. 1995;77-A(6):937–939.

    Google Scholar 

  50. Chung DC, et al. Anesthesia of the airway by aspiration of lidocaine. Can J Anaesth. 1999;46(3):215–219.

    CAS  PubMed  Google Scholar 

  51. Drummond JC, et al. Airway anesthesia: the toothpaste method. Can J Anaesth. 2000;47(1):94.

    CAS  PubMed  Google Scholar 

  52. Jones JM, Bramhall J. Airway anaesthesia during fibreoptic endoscopy. Can J Anaesth. 1997;44(7):785.

    CAS  PubMed  Google Scholar 

  53. Vloka J, et al. A simple adaptation to the Olympus LF1 and LF2 flexible fiberoptic bronchoscopes for instillation of local anesthetic. Anesthesiology. 1995;82(3):792.

    Article  CAS  PubMed  Google Scholar 

  54. Bacon GS, et al. Dyclonine hydrochloride for airway anesthesia: awake endotracheal intubation in a patient with suspected local anesthetic allergy. Anesthesiology. 1997;86(5):1206–1207.

    Article  CAS  PubMed  Google Scholar 

  55. Benumof JL, et al. Upper airway obstruction. Can J Anaesth. 1999;46(9):906.

    CAS  PubMed  Google Scholar 

  56. Wong D, McGuire GP. Subcutaneous emphysema following trans-cricothyroid membrane injection of local anesthetic. Can J Anaesth. 2000;47(2):165–168.

    CAS  PubMed  Google Scholar 

  57. Dunn SM, Pulai I. Forced air warming can facilitate fiberoptic intubations. Anesthesiology. 1998;88(1):282.

    Article  CAS  PubMed  Google Scholar 

  58. Roberts JT, et al. Why cervical flexion facilitates laryngoscopy with a Macintosh laryngoscope, but hinders it with a flexible fiberscope. Anesthesiology. 1990;73:A1012.

    Google Scholar 

  59. Katsnelson T, et al. When the endotracheal tube will not pass over the flexible fiberoptic bronchoscope. Anesthesiology. 1992;76:151.

    CAS  PubMed  Google Scholar 

  60. Cossham PS. Fibreoptic orotracheal intubation. Br J Anaesth. 1999;83(4):683–684.

    CAS  PubMed  Google Scholar 

  61. Randell T. Response to Cossham. Br J Anaesth. 1999;83(4):683–684.

    Google Scholar 

  62. Krensavage TJ. Saline solution as lubrication to manipulate a stuck fiberoptic bronchoscope. Anesth Analg. 1999;88:965.

    Article  CAS  PubMed  Google Scholar 

  63. Aoyama K, et al. Jaw thrust maneuver for endotracheal intubation using a fiberoptic stylet. Anesth Analg. 2000;90:1457–1458.

    Article  CAS  PubMed  Google Scholar 

  64. Aoyama K, et al. The jaw support device facilitates laryngeal exposure and ventilation during fiberoptic intubation. Anesth Analg. 1998;86:432–434.

    Article  CAS  PubMed  Google Scholar 

  65. Aoyama K, et al. New jaw support device and awake fiberoptic intubation. Anesth Analg. 2000;91:1309–1310.

    Article  CAS  PubMed  Google Scholar 

  66. Johnson C, et al. Fiberoptic intubation facilitated by a rigid laryngoscope. Anesth Analg. 1991;72:714.

    CAS  PubMed  Google Scholar 

  67. Dennehy KC, Dupuis JY. Fibreoptic intubation in the anaesthetized patient. Can J Anaesth. 1996;43(2):197.

    CAS  PubMed  Google Scholar 

  68. Archdeacon J, Brimacombe J. Anterior traction of the tongue—a forgotten aid to awake fiberoptic intubation. Anaesth Intens Care. 1995;23(6):750–757.

    CAS  Google Scholar 

  69. Slots P, Reinstrup P. One way to ventilate patients during fibreoptic intubation. Acta Anaesthesiol Scand. 2001;45:507–509.

    Article  CAS  PubMed  Google Scholar 

  70. Chen L, et al. Continuous ventilation during transnasal fiberoptic bronchoscope-aided tracheal intubation. Anesth Analg. 1996;82(3):674.

    Article  CAS  PubMed  Google Scholar 

  71. Cavdarski A. Continuous ventilation during transnasal fiberoptic intubation. Anesth Analg. 1996;83:1133.

    Article  CAS  PubMed  Google Scholar 

  72. Reed AP. Predictable problems with flexible fiberoptic laryngoscopy. Mt Sinai J Med. 1995;62(1):31–35.

    CAS  PubMed  Google Scholar 

  73. Gupta B, et al. Oral fiberoptic intubation over retrograde guidewire. Anesth Analg. 1989;68:517.

    CAS  PubMed  Google Scholar 

  74. Audenaert SM, et al. Retrograde-assisted fiberoptic tracheal intubation in children with difficult airways. Anesth Analg. 1991;73:660.

    CAS  PubMed  Google Scholar 

  75. Downing GJ, Kibride HW. Evaluation of airway complications in high-risk preterm infants: application of flexible fiberoptic airway endoscopy. Pediatrics. 1995;95(4):567–572.

    CAS  PubMed  Google Scholar 

  76. Berkowitz RG. Neonatal upper airway assessment by awake flexible laryngoscopy. Ann Otol Rhinol Laryngol. 1998;107:75–80.

    CAS  PubMed  Google Scholar 

  77. Blanco G, et al. Fibreoptic nasal intubation in children with anticipated and unanticipated difficult intubation. Paediatric Anaesthesia. 2000;111:49–53.

    Google Scholar 

  78. Hakala P, et al. Orotracheal fibreoptic intubation in children under general anaesthesia. Paediatric Anaesthesia. 1997;7:371–374.

    Article  CAS  PubMed  Google Scholar 

  79. Monrigal JP, Granry JC. Excision of bronchogenic cysts in children using an ultrathin fibreoptic bronchoscope. Can J Anaesth. 1996;43(7):694–696.

    CAS  PubMed  Google Scholar 

  80. Gaitini LA, et al. Replacing the combitube by an endotracheal tube using a fibre-optic bronchoscope during spontaneous ventilation. J Laryngol Otol. 1998;112:786–787.

    CAS  PubMed  Google Scholar 

  81. Ovassapian A, et al. Fiberoptic tracheal intubation with combitube in place. Anesth Analg. 1993;76:S315.

    Google Scholar 

  82. Gaitini LA, et al. Fiberoptic-guided airway exchange of the esophageal-tracheal combitube in spontaneously breathing versus mechanically ventilated patients. Anesth Analg. 1999;88:193–196.

    Article  CAS  PubMed  Google Scholar 

  83. Kraft P, et al. Bronchoscopy via a redesigned combitube in the esophageal position: a clinical evaluation. Anesthesiology. 1997;86:1041–1045.

    Article  Google Scholar 

  84. Hawkins M, et al. Fibreoptic intubation using the cuffed oropharyngeal airway and Aintree intubation catheter. Anaesthesia. 1998;53:891–894.

    CAS  PubMed  Google Scholar 

  85. Greenberg RS, Kay NH. Cuffed oropharyngeal airway (COPA) as an adjunct to fiberoptic tracheal intubation. Br J Anaesth. 1999;82:395–398.

    CAS  PubMed  Google Scholar 

  86. Chen L. Continuous ventilation during trans-laryngeal mask airway fiberoptic bronchoscope-aided tracheal intubation. Anesth Analg. 1996;82:891–892.

    Article  CAS  PubMed  Google Scholar 

  87. Barnett RA, Ochroch EA. Augmented fiberoptic intubation. Crit Care Clinics. 2000; 16(3):453–462.

    CAS  Google Scholar 

  88. Hinton AE, et al. Neonatal and paediatric fibre-optic laryngoscopy and bronchoscopy using the LMA. J Laryngol Otol. 1997;111:349–353.

    CAS  PubMed  Google Scholar 

  89. Holmstrom A, Akeson J. Fibreoptic laryngotracheoscopy via the LMA in children. Acta Anaesth Scand. 1997;41:239–241.

    Article  CAS  PubMed  Google Scholar 

  90. Walker RWM, et al. A fibreoptic intubation technique for children with mucopolysaccharidoses using the LMA. Paediatric Anaesth. 1997;7:421–426.

    Article  CAS  Google Scholar 

  91. David I, et al. Jet ventilation for fiberoptic bronchoscopy. Anesthesiology. 2001; 94(5):930–932.

    Article  CAS  PubMed  Google Scholar 

  92. Ovassapian A, et al. Fibreoptic bronchoscope and unexpected failed intubation. Can J Anaesth. 1999;46:806–807.

    CAS  PubMed  Google Scholar 

  93. Roberts J. Fiberoptic intubation and alternative techniques for managing the difficult airway. ASA Refresher Course. 1999:136.

    Google Scholar 

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(2003). Fiberoptic Airway Management Techniques. In: Principles of Airway Management. Springer, New York, NY. https://doi.org/10.1007/0-387-22650-8_4

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  • DOI: https://doi.org/10.1007/0-387-22650-8_4

  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-0-387-22650-7

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