Turkish Journal of Anaesthesiology & Reanimation
Paediatric Anaesthesia - ORIGINAL ARTICLE

Single-Centre Open-Label Comparative Trial of Video-Assisted Fibreoptic-Bronchoscope-Guided Oral Versus Nasal Intubation in Anaesthetised Spontaneously Breathing Paediatric Patients

1.

Department of Anaesthesiology and Critical Care, VMMC and Safdarjung Hospital, Delhi, India

2.

Department of Anaesthesiology, Pain and Critical Care, AIIMS, New Delhi, India

3.

Department of Paediatric Surgery, VMMC and Safdarjung Hospital, Delhi, India

Turk J Anaesthesiol Reanim 2021; 49: 37-43
DOI: 10.5152/TJAR.2019.55453
Read: 179 Downloads: 70 Published: 14 January 2020

Objective: Flexible fibreoptic intubation is challenging in paediatric patients. Very few studies have compared fibreoptic intubation via oral and nasal routes in children. We hypothesised that the total time to a successful fibreoptic-guided tracheal intubation would be faster through the nasal route when compared to the oral route.

Methods: Sixty children aged 6–12 years were randomised to receive fibreoptic tracheal intubation through oral (group FOI) or nasal route (group FNI). We measured the time to glottic view and total time to successful tracheal intubation. The number of attempts needed, first attempt and overall success rate, external manoeuvres needed to obtain an adequate laryngeal view, subjective assessment of ease of intubation and complications, if any, were also recorded.

Results: The time to glottic view (76.26±.7 s vs. 46.33±16.9 s; p=0.001) and total intubation time (4.55±1.07 min vs. 3.05±0.60 min; p<0.0001) were significantly higher in the FOI group as compared to the FNI group. An overall success rate was 100% in the FNI group and 96.6% in the FOI group. The haemodynamic parameters (mean heart rate and blood pressures) changes were comparable in the two groups at all time intervals. The subjective assessment of ease of intubation was comparable in the two groups (p=0.21). Complications were minor and self-limiting.

Conclusion: Intubation guided by a nasal flexible fibreoptic bronchoscope is easier and faster when compared to oral intubation in children aged 6–12 years with normal airway, and it should be preferred for intubation in children requiring fibreoptic intubation.

Cite this article as: Sharma K, Ganapathy U, Gupta A, Bagga D. Single-Centre Open-Label Comparative Trial of Video-Assisted Fibreoptic-Bronchoscope-Guided Oral Versus Nasal Intubation in Anaesthetised Spontaneously Breathing Paediatric Patients. Turk J Anaesthesiol Reanim 2021; 49(1): 37-43.

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