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Indian J Otolaryngol Head Neck Surg. 2013 Apr;65(2):116-9. doi: 10.1007/s12070-012-0576-8. Epub 2012 Oct 17.

A study of flexible fiberoptic bronchoscopy aided tracheal intubation for patients undergoing elective surgery under general anesthesia.

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Department of Respiratory medicine, Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Waghodia, Vadodara, 391760 Gujarat India.
Department of ENT, Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Waghodia, Vadodara, 391760 Gujarat India.


A difficult airway complicates up to one tenths of cases of elective general anesthesia. Such situations can be anticipated and tackled by fiberoptic flexible bronchoscopy (FFB) assisted tracheal intubation. To study the indications and outcomes of FFB assisted tracheal intubation in patients with anticipated difficult airway, who are undergoing surgery under general anesthesia. Cases who were intubated using FFB assistance were included in the study. Detailed examination was done pre operatively to be able to predict the difficult airway. Intubation was done with the help of a FFB after induction of general anesthesia. There were total 52 cases. Majority were male and in the fourth decade of life. Oral submucous fibrosis was the commonest indication for the procedure. There were two cases of failure, but no significant mortality or morbidity. A difficult airway can be encountered across specialties. It can be anticipated by simple or multi factorial methods. Awake FFB aided intubation is the gold standard in cases of anticipated difficult airway. Failure rates of 4-66 % have been reported. In the present study the failure rate was less than 4 % with no morbidity or mortality. FFB assisted intubation is safe and effective in paediatric patients too. FFB assisted intubation done in an organised and skilled manner is a very important skill to have to tackle cases of difficult intubation. Hence it should be included in training programmes of anesthesia.


Difficult airway; Flexible fiberoptic bronchoscopy; General anesthesia; Tracheal intubation

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