Airway management is essential for general anesthesia and endotracheal intubation is the most useful and safe method to keep airway in general anesthesia. Numerous anatomic and pathologic abnormalities may lead to difficult intubation. Failed
endotracheal intubation may lead to organ ischemia and then it imminently endangers the patient's life and necessitates the other methods to ventilation.
In case of failed conventional endotracheal intubation, various methods are used. These methods include blind nasotracheal intubation, retrograde catheter insertion, laryngeal mask airway, and flexible fiberoptic bronchoscopic intubation.
We try to the flexible fiberoptic bronchoscopic inbation in expected difficult intubation, especially cervical fracture and cervical postburn contracture. In 20 patients, we review the clinical evaluation of awake fiberoptic broncoscopic
inbubation
with
Mallampati classfication, hemodnamic variables, discomfort during intubation procedure and postoperative complications. We measured the changes of arterial pressure and heart rate during flexible fiberoptic broncoscopic intubation.
@ES The results were as follows:
@EN 1. The most of patients revealed Mallampati class I or II.
2. The most of patients could not extend the neck because Halo traction and postburn contracture.
3. The systolic, diastolic and mean arterial pressure decreased significantly at 3 and/or 5 min. following intubation.
4. The heart rate increased significantly at 1 min. and 3 min. following intubation.
5. Any bleedign or edema of pharnyx and larynx were not found in postoperative fiberoptic laryngoscopic views.
6. In postoperative interviews, a few(2/20) patients complained discomfort during procedures. In conclusion, the flexible fiberoptic intubation is efective and safe alternative of the conventional intubation in difficult intubation.
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