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Updated: Mar 23, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
Is the Ambu aScope 3 Slim single-use fiberscope equally efficient compared with a conventional bronchoscope for
Tomoko Fukada1, Yuri Tsuchiya1, Hiroko Iwakiri1
1Department of Anesthesiology, Tokyo Women's Medical University, School of Medicine, 8-1 Kawadacho Shinjukuku, Tokyo 162-8666, Japan.
Study Objective:
The study objective was to evaluate whether the single-use fiberoptic bronchoscope (FOB), Ambu aScope 3 Slim, was equally efficient compared with the conventional reusable FOB, Olympus LF-GP, for nasal fiberoptic intubation in a manikin.
Design:
A randomized crossed-over study.
Setting:
The postanesthesia care unit of Tokyo Women's Medical University Hospital.
Subjects:
Twenty anesthesiologists who have experienced >50 one-lung ventilation thoracic surgery procedures were invited to participate in this study.
Interventions:
A 6.5-mm internal diameter cuffed endotracheal tube (ET) was inserted into the manikin under Ambu aScope 3 Slim (group A) or Olympus LF-GP (group C) guidance.
Measurements:
The following time parameters from the beginning of FOB insertion through a nostril were compared between groups: until vocal cord visualization (T1); visualization of the carina (T2); and proper ET placement, as confirmed by the distance of the ET tip to carina (T3).
Main Results:
Mean (SD) T1 in group A and group C were 20 seconds (17 seconds) and 14 seconds (12 seconds), respectively (P= .1050). Mean (SD) T2 in group A and group C were 40 seconds (29 seconds) and 25 seconds (15 seconds), respectively (P= .0287). Mean (SD) T3 in group A and group C were 70 seconds (33 seconds) and 50 seconds (22 seconds), respectively (P= .0098). One case in group A had failed intubation
Conclusions:
The Ambu aScope 3 Slim required more time to intubate than the conventional reusable FOB. It requires more rigidity, similar to the conventional FOB for management of the difficult airway.
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