Comparison between two fibrescopes with different diameter insertion cords for fibreoptic intubation

Area of Science:

• Anesthesiology
• Respiratory Medicine
• Medical Devices

Background:

• Fiberoptic intubation is a key technique for managing difficult airways.
• Bronchoscope insertion cord diameter may influence intubation success and ease.

Purpose of the Study:

• To compare the efficacy of two fiberoptic bronchoscopes with different insertion cord diameters (3.7 mm vs. 5.0 mm) for orotracheal intubation.
• To evaluate the impact of bronchoscope diameter on intubation success rates, resistance, duration, and complications.

Main Methods:

• A randomized comparison of two fiberoptic bronchoscopes (3.7 mm and 5.0 mm insertion cords) during orotracheal intubation.
• Study included 84 adult patients (ASA 1-2) under general anesthesia.
• Outcomes assessed included resistance, intubation failure, need for manipulation, duration, and esophageal intubation.

Main Results:

• Higher incidence of resistance to tracheal tube passage through vocal cords with the thinner (3.7 mm) scope (35%) compared to the thicker (5.0 mm) scope (11%) (p < 0.05).
• Intubation failure occurred in 20% of patients with the thinner scope, versus 0% with the thicker scope (p < 0.01).
• Intubation duration was significantly shorter with the thicker scope (p < 0.05), and two instances of esophageal intubation occurred with the thinner scope.

Conclusions:

• A fiberoptic bronchoscope with a thicker insertion cord (5.0 mm) is more suitable for orotracheal fiberoptic intubation in adult patients.
• Thicker insertion cords are associated with reduced resistance, higher success rates, and shorter intubation times.
• The findings support the use of thicker insertion cord bronchoscopes for improved fiberoptic intubation outcomes.