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Canadian Journal of Anaesthesia

, Volume 41, Issue 10, pp 996–1008 | Cite as

Fibreoptic intubation

  • Ian R. Morris
Continuing Medical Education

Abstract

Although not widely utilized, fibreoptic techniques represent a dramatic advance in the management of the difficult intubation. Particularly suited to the awake patient in the elective setting, fibreoptic intubation can abo be useful in selected emergency situations, and can be done under general anaesthesia. In the awake patient fibreoptic intubation maintains a wide margin of safety while producing minimal patient discomfort, but requires adequate local anaesthesia of the airway. Intimate familiarity with the bronchoscope and the anatomy of the upper airway is essential as is careful attention to various aspects of technique. Intubation mannequins can be readily utilized to develop dexterity in bronchoscopic manipulation and intubation workshops are also effective in improving skills. This CME article provides the clinician with a detailed approach to the technique of fibreoptic intubation based on the author’s personal experience supplemented by a limited literature review. Fibreoptic intubation is not a difficult skill to master and should be in the armamentarium of all practising anaesthetists.

Key words

airway: anaesthesia equipment: bronchoscopes, fibreoptic intubation: fibreoptic, technique 

Résumé

Sans être universellement utilisée, la fibroscopie constitue un progrès intéressant pour la prise en charge des voies aériennes difficiles. Particulièrement adaptée au malade éveillé pour des interventions programmées, l’intubation fibroscopique est aussi utile en urgence et réalisable sous anesthésie générale. Chez le patient éveillé, l’intubation fibroscopique parmet une grande marge de sécurité avec désagrément minime, mais nécessite une anesthésie locale adéquate des voies respiratoires. Il faut bien connaître le bronchoscope, l’anatomie des voies respiratoires supérieures et les particularités de la technique. Des mannequins peuvent être utilisés pour développer la dextérité nécessaire à la manipulation du bronchoscope et les ateliers d’enseignement sont efficaces. Cet article d’enseignement médical continu fournit au clinicien un accès détaillé à la technique d’intubation fibroscopique basée sur l’expérience personnelle de l’auteur avec une brève revue de la littérature. L’intubation fibroscopique n’est pas difficile à maîtriser et devrait faire partie de l’arsenal de tous les anesthésistes en exercice.

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Copyright information

© Canadian Anesthesiologists 1994

Authors and Affiliations

  • Ian R. Morris
    • 1
  1. 1.Department of AnaesthesiaDalhousie University and the Victoria General HospitalHalifax

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