Understanding Anesthesiology - The Global Regional Anesthesia ...

Fibreoptic bronchoscope
Fibreoptic bronchoscopy is the approach that is used when performing an awake intubation.
After applying topical anesthetic to the airway, the anesthesiologist uses a fibreoptic bronchoscope
(loaded with an endotracheal tube) to identify and pass through the larynx into the trachea.
Once in the trachea, the bronchoscope serves as a guide over which the endotracheal
tube is passed.
Fibreoptic bronchoscopy is used in the management of patients with airways that are known
or suspected to be “difficult” from the perspective of direct laryngoscopy. Fibreoptic intubations
are also indicated in patients with unstable cervical spines because they can be performed
with the neck in the neutral position rather than in the sniffing position. It is also
used in the occasional patient with very limited mouth opening as it can be passed though
the smallest of openings.
Fibreoptic bronchoscopic intubations are usually performed on the awake patient. Opioids
and/or anxiolytics are used judiciously as adjuncts to blunt the cough reflex as well as to
make the experience more palatable for the patient.
Fibreoptic bronchoscopy is not easily performed on the anesthetized patient. After the tube
is placed, anesthesia is then induced.
The fibreoptic bronchoscope, passed through an existing endotracheal tube, can be also used
by the anesthesiologist to examine the lower airways and remove secretions or other matter.
Related Glossary Terms
Adjunct, Airway assessment, Antisialagogue, Cough reflex, Difficult airway, Direct laryngoscopy,
Intubation, Laryngoscope, Larynx, Lower airway, Mallampati classification, Midazolam,
Mouth opening, Neck motion, Opioids, Sniffing position
Index
Find Term
Chapter 1 - Airway Management