Comparison of two methods of fibrescope-guided tracheal intubation

We have compared intubation time and cardiovascular effects of fibrescope-guided orotracheal intubation aided by the Berman 11 Intubating Airway with those of the tongue traction method of fibreoptic intubation and with conventional Macintosh intubation. We studied 75 patients who received a standard general anaesthetic which included non-depolarizing neuromuscular block; they were allocated randomly to one of the three groups immediately before intubation. The mean time required to effect Berman airway intubation (34.9 s) was similar to that required for tongue traction intubation (35.3 s) and significantly greater than that required for Macintosh intubation (11.7 s). The cardiovascular responses to both types of fibreoptic intubation were significantly greater and more prolonged than those of Macintosh intubation. There were no significant differences between the responses to the two fibreoptic techniques. Haemodynamic effects should be considered when performing fibrescope-guided tracheal intubation under general anaesthesia and, when necessary, appropriate measures should be taken to minimize them.