Tracheal intubation with the aid of fiberoptic bronchoscopy with or without the C-MAC device in patients with a suspected difficult airway undergoing elective uvulopalatopharyngoplasty

Abstract EN

Background Endotracheal intubation is considered as the defi nitive method of airway management.

Diffi culty encountered during direct laryngoscopy for the intubation process is one aspect of the overall problems in airway management.

Fiberoptic bronchoscopy ( FOB) represents a signifi cant advancement in the management of patients with a diffi cult airway.

C-MAC videolaryngoscopes present a new approach for the management of diffi cult laryngoscopy.

Patients and methods Sixty patients, of both sexes, aged 20–50 years, ASA I–II, undergoing an elective uvulopalatopharyngoplasty surgery were included.

Patients were allocated randomly to be intubated using FOB (F group) or FOB plus C-MAC videolaryngoscopy ( F- CMAC group).

Collected data included grades of the Cormack–Lehane laryngeal view, success or failure of the technique, the number of attempts, the duration of the successful attempt, and hemodynamic measurements throughout the intubation procedure.

Complications (such as oxygen desaturation, patient distress, soft tissue damage, gagging/vomiting, bradycardia and hypotension, laryngospasm, and bronchospasm) were recorded.

Results There was a signifi cant decrease in the duration of the successful attempt, the number of intubation trials, and Cormack–Lehane grades regarding the laryngeal view as well as a decrease in the number of patients who needed facilitating techniques in group F-CMAC compared with group F.

No signifi cant difference was found on comparing the heart rate, the mean arterial pressure, and the incidence of complications during intubation between the two groups.

Conclusion The C-MAC videolaryngoscope with fi beroptic bronchoscopy allows a signifi cantly faster intubation time, with a decrease in the duration of the successful attempt, fewer intubation trials, and a better grade of laryngeal views assessed by Cormack–Lehane grades, with a decrease in the number of patients who needed facilitating techniques and a comparable incidence of complications during intubation compared with fi beroptic alone for tracheal intubation in patients with a suspected diffi cult airway undergoing elective uvulopalatopharyngoplasty.