A modified Guedel airway for continuous oxygenation and suctioning during fibreoptic bronchoscopy

We describe a modification to the Guedel airway that improves suction and oxygenation during fibreoptic bronchoscopy. The entire roof of a Guedel airway was removed. Two 2.5-mm internal diameter tracheal tubes were inserted into the modified airway to allow continuous oxygen delivery and suction throughout fibreoptic bronchoscopy. It was tested as a single-use device in ten patients undergoing awake fibreoptic bronchoscopy under sedation and topical anasthesia. During the procedure there were no problems with either fogging of the lens or secretions in the pharynx. In addition, oxyhaemoglobin saturation, as monitored continuously by pulse oximetry, was >/= 97% in all patients.