Yeungnam Univ J Med.  2007 Dec;24(2):154-161.

The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation

• Lee DH
• Kwon IC

Abstract

BACKGROUND: This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation.
MATERIALS AND METHODS
For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation.
RESULTS
The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a SpO2<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01).
CONCLUSION
In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

Keyword

Bonfils intubation fibrescope; Difficult tracheal intubation

MeSH Terms

Classification
Humans
Intubation*
Laryngoscopy