Oral Fibreoptic Intubation – A Comparison of Simple Pre-Determined Length Insertion Technique (Split) With Conventional Method: A Randomized Cross-Over Study

M Balasubramani

M Balasubramani Government Theni Medical College, Theni, Tamil Nadu, India

Keywords: Conventional technique, Oral fiberoptic intubation, SPLIT

Abstract

Introduction: The flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation remains the gold standard in difficult airway management in spite of many newer airway gadgets. FOB-guided intubation can be performed through nasal or oral route either in awake or anaesthetised patients.
Aim: To evaluate the simple pre-determined length insertion technique (SPLIT) during oral fibreoptic intubation.
Methods: In this randomized cross-over study 18 - 65 years, ASA 1 and 2, Patients undergoing general anaesthesia patients were included. Video-assisted flexible fiber-optic laryngoscopy was performed using SPLIT (Group-A) (n-30) and by using conventional method (Group-B) (n-30). Introduction of fiberscope from the incisors to the visualization of glottis (T1), Time taken from the visualization of glottis to the passage of fiber-optic tip just beyond glottis (T2), Time from the incisors to pass it beyond the glottis (T3), were noted.
Results: T1 is reduced in SPLIT (12 ± 1.58 sec) when compared to conventional method (43 ± 1.68 sec) and is statistically significant (p< 0.0001).T2 is equal in SPLIT (11 ± 1.23 sec) and conventional method (12 ± 1.47 sec) which is statistically insignificant (p>0.05). T3 is reduced while using SPLIT (13 ± 2.03 sec) when compared to conventional method (55 ± 1.57 sec) and is statistically significant (p< 0.0001).
Conclusion: SPLIT significantly lessened the time to visualize the glottis than the conventional technique. The SPLIT can be used as a preferred technique to secure the airway at the earliest and also as an alternative to conventional technique.

Author Biography

M Balasubramani, Government Theni Medical College, Theni, Tamil Nadu, India

Associate Professor, Department of Anaesthesiology,

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