Do we have an "ideal" protocol in the intubation with fibrobronchoscope in the patient with difficult anticipated airway?: A review.

Abstract

Intubation with fibrobronchoscope in the awake patient is a good option form patient with a known difficult airway who are going to undergo a scheduled surgical intervention, which allows the responsable anesthesiologist to devise a plan of action to prevent an unwanted outcome. There are many protocols that are applied for this but most of the time are due to the experience of each anesthesiologist and the results obtained with application in the usual care practice.

This article is the first systematic review or randomized clinical trials focusing on this approach. Information was mainly selected from four areas of work: premedication, sedation, local anesthesia and the use of devices and auxiliary techniques to facilitate intubation in the awake patient. The authors find a great heterogeneity as far as these aspects are concerned, without any of the protocols having demonstrated superiority in safety and efficacy.