Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Mar;60(3):110-118.
doi: 10.11622/smedj.2018081. Epub 2018 Jul 16.

Fibreoptic intubation in airway management: a review article

Jolin Wong  1 , John Song En Lee  1 , Theodore Gar Ling Wong  1 , Rehana Iqbal  2 , Patrick Wong  1
Affiliations
Review

Fibreoptic intubation in airway management: a review article

Jolin Wong et al. Singapore Med J. 2019 Mar.

Abstract

Since the first use of the flexible fibreoptic bronchoscope, a plethora of new airway equipment has become available. It is essential for clinicians to understand the role and limitations of the available equipment to make appropriate choices. The recent 4th National Audit Project conducted in the United Kingdom found that poor judgement with inappropriate choice of equipment was a contributory factor in airway morbidity and mortality. Given the many modern airway adjuncts that are available, we aimed to define the role of flexible fibreoptic intubation in decision-making and management of anticipated and unanticipated difficult airways. We also reviewed the recent literature regarding the role of flexible fibreoptic intubation in specific patient groups who may present with difficult intubation, and concluded that the flexible fibrescope maintains its important role in difficult airway management.

Keywords: airway obstruction; anaesthetic techniques; fibreoptic intubation; neuromuscular blocking.

PubMed Disclaimer

Figures

Box 1
Box 1
Indications and uses of the flexible fibreoptic bronchoscope
Box 2
Box 2
Contraindications (absolute/relative) to flexible fibreoptic intubation
Box 3
Box 3
Advantages and disadvantages of awake and asleep fibreoptic intubation
Box 4
Box 4
Advantages and disadvantages of awake intubation using videolaryngoscopy (VL) vs. awake fibreoptic intubation (FOI)
See this image and copyright information in PMC

References

    1. Szmuk P, Ezri T, Evron S, Roth Y, Katz J. A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age. Intensive Care Med. 2008;34:222–8. - PubMed
    1. Fitzgerald E, Hodzovic I, Smith AF. 'From darkness into light':time to make awake intubation with videolaryngoscopy the primary technique for an anticipated difficult airway? Anaesthesia. 2015;70:387–92. - PubMed
    1. Murphy P. A fibre-optic endoscope used for nasal intubation. Anaesthesia. 1967;22:489–91. - PubMed
    1. 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. - PubMed
    1. Heidegger T, Gerig HJ. Algorithms for management of the difficult airway. Curr Opin Anaesthesiol. 2004;17:483–4. - PubMed

LinkOut - more resources