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Awake intubations utilising a rigid endoscope in a regional hospital setting: a case series
EP31396
Poster Title: Awake intubations utilising a rigid endoscope in a regional hospital setting: a case series
Submitted on 08 Mar 2020
Author(s): JHLR Jacobs, JG Davids, F Roodt
Affiliations:
This poster was presented at SASA Congress 2020
Poster Views: 289
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Poster Information
Abstract: Traditionally, the use of a flexible bronchoscope for awake tracheal intubation is
seen as the gold standard in the management of an anticipated difficult airway. We
present two cases that were admitted to our unit with severe stridor, necessitating
immediate airway intervention: a 63 year old male with an intermittently obstructing
airway secondary to a laryngeal tumour, and a 58 year old female with a suspected
laryngopyocoele. We performed midline fibreoptic oral intubations using a Bonfils
endoscope under minimal sedation and topical anaesthesia of the airways. The
Bonfils is a rigid fibreoptic endoscope with a 5.0mm diameter and 40-degree
curvature at the distal end. We propose that a rigid endoscope should be utilized
more often in awake tracheal intubations, as it can pass soft tissues easily and lift
airway structures. It is durable, easy to clean and has a gentle learning curve,
making it especially useful in a regional hospital setting.
Summary: A case series utilising a rigid endoscope, the bonfils, for awake intubations in difficult airways in a regional hospital setting in South Africa.References: 1. Ahmad I, El-Boghdadly K, Bhagrath R, et al. Difficult Airway Society guidelines for awake tracheal
intubation (ATI) in adults. Anaesthesia. 2019; PMID: 31729018
2. Apfelbaum JL, Hagberg CA, Caplan RA, et al. American Society of Anesthesiologists Task Force on
Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an
updated report by the American Society of Anesthesiologists Task Force on Management of the
Difficult Airway. Anesthesiology. 2013;118:251–70.
3. Wong J, Lee JSE, Wong TGL, Iqbal R, Wong P. Fibreoptic intubation in airway management: a
review article. Singapore Med J. 2019;60(3):110–118.
4. Corbanese U, Possamai C. Awake intubation with Bonfils Fiberscope in patients with difficult
Airways. Eur J Anaesthesiol. 2009;26:837–41.
5. Wahlen BM, Gercek E. Three-dimensional cervical spine movement during intubation using the
Macintosh and Bullard laryngoscopes, the Bonfils fiberscope and the in
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