The effectiveness of the Bonfils intubation fibrescope for endotracheal intubation / 대한마취과학회지

BACKGROUND: This study was conducted to evaluate the effectiveness of the Bonfils intubation fibrescope for endotracheal intubation. METHODS: 78 patients aged 21 to 85 years underwent direct laryngoscopy and the laryngoscopic view was then graded according to the Cormack & Lehane classification. The patients were subsequently intubated with a Bonfils intubation fibrescope and the success rate for tracheal intubation, time to intubation, number of attempts and adverse effects were recorded. In addition, the thyromental distance was recorded following the orotracheal intubation. RESULTS: The success rate for tracheal intubation was > 95% in patients graded 1 to 3 and 63.5% in patients with a grade of 4. The time to intubation was significantly faster in patients graded 1 to 3 than in those with a grade of 4 (175.2 +/- 137.1) (P < 0.01). Third attempts were required more often in patients with a higher grade. The number of patients with a SpO2 < 90% was below 5% in patients with a grade of 1 to 3 and 58.8% in patients with a grade of 4. CONCLUSIONS: The Bonfils intubation fibrescope is an effective instrument for endotracheal intubation in patients with a grade of 1 to 3, however, tracheal intubation using the Bonfils intubation fibrescope was unsuccessful in some patients with a grade of 4. Therefore, other effective instruments should be considered for use in cases of failed direct laryngoscopy or in patients for which a difficult airway is predicted.

The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation / 영남의대학술지

BACKGROUND: This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. MATERIALS AND METHODS: For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. RESULTS: The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a SpO2<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). CONCLUSION: In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

A Comparison of Hemodynamic Changes after Endotracheal Intubation by using the Bonfils Intubation Fibrescope and the Laryngoscope / 대한마취과학회지

BACKGROUND: The hemodynamic changes associated with orotracheal intubation may result from direct laryngoscopy and the endotracheal intubation. This study evaluated and compared the cardiovascular changes after either Bonfils intubation fibrescope or conventional laryngoscopic endotracheal intubation. METHODS: Sixty patients, aged 20 to 30 years, were randomly allocated into two groups, the Bonfils intubation fibrescope group (BF group, n = 30) and conventional intubation using a rigid laryngoscope (LS group, n = 30). Bonfils intubation fibrescope or laryngoscopic oral endotracheal intubation was performed after inducing anesthesia. The systolic and diastolic arterial pressures, heart rate, peripheral oxygen saturation and intubation time were recorded before and after orotracheal intubation. RESULTS: In both groups, the systolic and diastolic arterial pressures increased significantly after endotracheal intubation. The heart rate increased significantly after the induction of anesthesia in both groups. However, the arterial blood pressure, heart rate and intubation time were similar in both groups. CONCLUSIONS: The use of a Bonfils intubation fibrescope does not modify the hemodynamic response associated with endotracheal intubation compared with conventional laryngoscopy.