[Tracheal intubation using bronchofiberoscopy (experience of a hospital service)]

Fiberoptic endoscopy has brought about significant progress in the management of so-called difficult intubations. We describe the techniques applied and results in one hospital service performing intubation guided by fiberoptic bronchoscope (FB). A total of 512 consecutive intubations (64.18% men and 35.15% women) performed over the past 18 years were analyzed. Non-tumor related disease of the cervical column (28.91%) was the most frequent cause of difficult intubation requiring FB guidance, followed by trauma (18.16%) and technical difficulties (17.39%). A nasal route was used most often (80.86%). In 93.16% of cases, intubation was needed for surgery. Thirty-five (6.84%) complications of various types were recorded, and intubation was impossible in 3 (0.59%) cases. Intubation in patients under general anesthesia presented special technical difficulties due to loss of muscle tone and the need to maintain ventilation. We recommend intubation only in patients who are breathing spontaneously through the nose, using lidocaine as a local anesthetic and a large caliber endotracheal tube with as small a tip as possible.