How Many Attempts are Needed for Learning Fiberoptic Orotracheal Intubation? / 대한마취과학회지

ABSTRACT

BACKGROUND: The value of the fiberoptic laryngoscope in difficult tracheal intubation is well established. In recent years there has been a significant interest in and increase in learning this valuable skill by anesthesiologists. This study assesses the minimum number of attempts needed for proficiency in fiberoptic orotracheal intubation. METHODS: Eight anesthesia residents with experience in rigid larygoscopic intubation, but who were beginners in fiberoptic intubation, participated in this study. In a randomized fashion, each resident performed 50 fiberoptic orotracheal intubations. All intubations were performed under general anesthesia and muscle paralysis. Success rate and intubation time of fiberoptic orotracheal intubation and SpO2 were recorded. We have compared success rate with intubation time of fiberoptic orotracheal intubation and grade of laryngoscopic view. RESULTS: The mean success rate of fiberoptic orotracheal intubation was 75% in the first 10 intubations. Thereafter the success rates were higher than 90%. The mean time to achieve successful orotracheal fiberoptic intubation were significantly decreased to 30 attempts. There was no correlation of laryngoscopic grade with intubation time and success rate. No hypoxia occurred in any patient. CONCLUSIONS: We concluded that an acceptable level of technical expertise in fiberoptic orotracheal intubation is achieved after 30 intubation attempts.