J T Roberts1. 1. Department of Anaesthesia, Massachusetts General Hospital, Boston 02114.
Abstract
STUDY OBJECTIVE: To describe a current method of teaching flexible fiber-optic laryngoscopy. DESIGN: Review of a current technique. SETTING: Inpatient surgery area at a university medical center. PATIENTS: More than 1,000 ASA physical status I and II patients requiring general endotracheal anesthesia for renal lithotripsy were intubated orally using a flexible fiber-optic laryngoscope. INTERVENTIONS: Patients were given a sleep dose of thiopental sodium (4 mg/kg) and paralyzed with a bolus of succinylcholine (1 mg/kg). MEASUREMENTS AND MAIN RESULTS: Peripheral oxygen (O2) saturation, capnography, electrocardiography (EKG), automated blood pressure (BP) measurements, and clinical response of the patients were closely monitored by the attending anesthesiologist. Three obese patients rapidly desaturated, leading to abandonment of the technique for teaching purposes. After ventilation with 100% O2, all 3 patients were rapidly intubated orally by the instructor using the flexible fiber-optic technique. CONCLUSIONS: Oral flexible fiber-optic laryngoscopy and intubation may be taught safely using thiopental sodium and succinylcholine by adhering to the guidelines outlined in this paper.
STUDY OBJECTIVE: To describe a current method of teaching flexible fiber-optic laryngoscopy. DESIGN: Review of a current technique. SETTING: Inpatient surgery area at a university medical center. PATIENTS: More than 1,000 ASA physical status I and II patients requiring general endotracheal anesthesia for renal lithotripsy were intubated orally using a flexible fiber-optic laryngoscope. INTERVENTIONS:Patients were given a sleep dose of thiopental sodium (4 mg/kg) and paralyzed with a bolus of succinylcholine (1 mg/kg). MEASUREMENTS AND MAIN RESULTS: Peripheral oxygen (O2) saturation, capnography, electrocardiography (EKG), automated blood pressure (BP) measurements, and clinical response of the patients were closely monitored by the attending anesthesiologist. Three obesepatients rapidly desaturated, leading to abandonment of the technique for teaching purposes. After ventilation with 100% O2, all 3 patients were rapidly intubated orally by the instructor using the flexible fiber-optic technique. CONCLUSIONS: Oral flexible fiber-optic laryngoscopy and intubation may be taught safely using thiopental sodium and succinylcholine by adhering to the guidelines outlined in this paper.