Clinical Study Of The Bonfils Intubation Fiberscope

Part One: A clinical evaluation of Bonfils intubation fibrescopeObjective : To observe the clinical effect of Bonfils intubation fiberscope-guide intubation and compare effects of three manoeuvres of jaw thrust on Bonfils intubation fiberscope-guide intubation in adult patients with normal airways. Methods: 90 ASA classⅠ～Ⅱadult patients undergoing selective plastic surgery and requiring orotracheal intubation were allocated to three groups, control group, chin lift group and external jaw thrust group. After intravenous anesthesia induction, all patients were intubated with Bonfils intubation fiberscope. The number of intubation attempts, the duration of each intubation attempt, hemodynamic changes , the incidence of intubation-related intraoral injury, and postoperative sore throat and complaint were recorded. Results: Tracheal intubation were all successful in three groups on the first attempt. The duration of intubation in external jaw thrust group( 18. 9±10. 3s)was significantly shorter than that in chin lift group (33. 7±29. 4s) and control group (44. 6±38. 9s) . The effects of intubation on hemodynamics among three groups were all similar. Conclusion : Bonfils intubation fiberscope is easy to manipulate with higher success rate and minimal injury to oral cavity. Chin lift and external jaw thrust can shorten manipulation time, and the time in the way of external jaw thrust by an assistant is the shortest. Part Two: An evaluation of light transillumination for Bonfils intubation fiberscope.Objective: To evaluate the feasibility of light transillumination for Bonfils intubation fiberscope-guide intubation in adult patients with normal airway. Methods: 100 ASA classⅠ～Ⅱadult patients undergoing selective plastic surgery and requiring orotracheal intubation were allocated to either routine intubation group or external jaw thrust group randomly. After intravenous anesthesia induction, the patients were intubated with Bonfils intubation fiberscope by light transillumination in natural room light . The times and the duration of looking for glottis, the intubation time, hemodynamic changes and the incidence of intubation-related intraoral injury were recorded. Results: Tracheal intubation success rate with light transillumination were 96% (48/50) and 98% (49/50) , the average time of looking for glottis were (14.9±1.3) s and (9.8±7.8) s, (P<0. 05) , and the intubation time were (24.6±14.1) s and (16.2±8.2) s, (P<0. 05) , in routine intubation group and external jaw thrust group, respectively. The effects of intubation on hemodynamics in both groups were all minimal. Conclusion: Light transillumination for Bonfils intubation fiberscope-guide intubation is easy to manipulate, higher success rate and minimal cardiovascular responses. It is shorter duration of looking for glottis and intubation manipulation when one assistant performing external jaw thrust.