[Teaching the use of fiberoptic intubation in anesthetized patients]

Fiberoptic bronchoscope (FOB)-guided intubation is an important and useful technique for unanticipated difficult airway in anesthetized patients. However, many staff anesthesiologists seemed to find it difficult to perform. We speculated that it was because they had not been well trained in the technique. We worked out an easy method for FOB-guided intubation. We had our residents try our method and measured the elapsed time in introducing FOB from the mouth to the tracheal carina.

After IRB approval and having obtained informed consent, we enrolled twenty residents with experience of two to four years and twenty patients scheduled for thoracic surgery. After induction of anesthesia, we inserted a Berman airway and let the residents try to introduce FOB from the mouth to the tracheal carina. Staff anesthesiologists gave verbal advises only by watching the video image and we measured the elapsed time.

The elapsed time was 83+/-43 sec (mean+/-SD). Although three residents required interruptions for ventilation during their trials, they were able to accomplish their missions in their second or third attempt. In all cases, Sp02 was kept at 100% throughout the trials.

We showed that our method helped anesthesiologists to master FOB-guided intubation.