기관내 삽관 시 Bonfils Intubation Fibrescope의 유용성 = The effectiveness of the Bonfils intubation fibrescope for endotracheal intubation

다국어 초록 (Multilingual Abstract)

This study was conducted to evaluate the effectiveness of the Bonfils intubation fibrescope for endotracheal intubation.
Methods: 78 patients aged 21 to 85 years underwent direct laryngoscopy and the laryngoscopic view was then graded according to the Cormack & Lehane classification. The patients were subsequently intubated with a Bonfils intubation fibrescope and the success rate for tracheal intubation, time to intubation, number of attempts and adverse effects were recorded. In addition, the thyromental distance was recorded following the orotracheal intubation.
Results: The success rate for tracheal intubation was ＞95% in patients graded 1 to 3 and 63.5% in patients with a grade of 4. The time to intubation was significantly faster in patients graded 1 to 3 than in those with a grade of 4 (175.2 ± 137.1) (P ＜ 0.01). Third attempts were required more often in patients with a higher grade. The number of patients with a SpO2 ＜90% was below 5% in patients with a grade of 1 to 3 and 58.8% in patients with a grade of 4.
Conclusions: The Bonfils intubation fibrescope is an effective instrument for endotracheal intubation in patients with a grade of 1 to 3, however, tracheal intubation using the Bonfils intubation fibrescope was unsuccessful in some patients with a grade of 4. Therefore, other effective instruments should be considered for use in cases of failed direct laryngoscopy or in patients for which a difficult airway is predicted.

다국어 초록 (Multilingual Abstract)

This study was conducted to evaluate the effectiveness of the Bonfils intubation fibrescope for endotracheal intubation.
Methods: 78 patients aged 21 to 85 years underwent direct laryngoscopy and the laryngoscopic view was then graded according to the Cormack & Lehane classification. The patients were subsequently intubated with a Bonfils intubation fibrescope and the success rate for tracheal intubation, time to intubation, number of attempts and adverse effects were recorded. In addition, the thyromental distance was recorded following the orotracheal intubation.
Results: The success rate for tracheal intubation was ＞95% in patients graded 1 to 3 and 63.5% in patients with a grade of 4. The time to intubation was significantly faster in patients graded 1 to 3 than in those with a grade of 4 (175.2 ± 137.1) (P ＜ 0.01). Third attempts were required more often in patients with a higher grade. The number of patients with a SpO2 ＜90% was below 5% in patients with a grade of 1 to 3 and 58.8% in patients with a grade of 4.
Conclusions: The Bonfils intubation fibrescope is an effective instrument for endotracheal intubation in patients with a grade of 1 to 3, however, tracheal intubation using the Bonfils intubation fibrescope was unsuccessful in some patients with a grade of 4. Therefore, other effective instruments should be considered for use in cases of failed direct laryngoscopy or in patients for which a difficult airway is predicted.

참고문헌 (Reference)

1 Bein B, "Tracheal intubation using the Bonfils intubation fibrescope after failed direct laryngoscopy" 59 : 1207-1209, 2004

2 Wahlen BM, "Three-dimensional cervical spine movement during intubation using the Macintosh and Bullard laryngoscopes, the bonfils fibrescope and the intubating laryngeal mask airway" 21 : 907-913, 2004

3 Rudolph C, "Movement of the upper cervical spine during laryngoscopy: a comparison of the Bonfils intubation fibrescope and the Macintosh laryngoscope" 60 : 668-672, 2005

4 Bonfils P, "Fiberoptic intubation" 8 : 53-60, 1983

5 Bein B, "A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways" 59 : 668-674, 2004

6 Halligan M, "A clinical evaluation of the Bonfils intubation fibrescope" 58 : 1087-1091, 2003