title: [Fiberoptic intubation in adult patients with predictive signs of difficult intubation: inhalational induction using sevoflurane and an endoscopic facial mask].
abstract: OBJECTIVE
  To evaluate the combination of inhalational induction with sevoflurane and fiberoptic intubation through a specific facial mask for anticipated difficult tracheal intubation (DI) in adults.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Eighteen consecutive patients at risk of DI. After premedication made of hydroxyzine 2 mg x kg(-1), preoxygenation, 0.1 microg x kg(-1) sufentanil was administered (T0), then, inhalational induction was started: sevoflurane 8% in 100% O2 l x min(-1). After 1 min, sevoflurane was decreased to 5% and, if necessary, adapted to obtain an adequate depth of anaesthesia (Ramsay score > 3). Fiberoptic bronchoscopy was performed through a Fibroxy mask. BP was measured every 2.5 min, HR, SpO2, RR were recorded. The results were analyzed by Newman-Keuls test.
  
  
  RESULTS
  Intubation was easily realized but it was necessary to assist ventilation in patients presenting prolonged apnea lasting more than 30 s (5 out of 9 patients who presented apnea during procedure). Intubation was quickly realized (T+ 4 +/- 3 min). Haemodynamics and saturation were not altered during procedure. Inhalatory induction using sevoflurane costs 6 10 versus 16 80 for intravenous target controlled propofol anesthesia (using only one preconditionned syringe).
  
  
  CONCLUSIONS
  Inhalational induction with sevoflurane and fiberoptic intubation appeared easy, fast and cheap.
authors.affiliation: Service de réanimation polyvalente, département d'anesthésie-réanimation-urgences, HIA Legouest, BP10, 57998, Metz-Armée, France. legouest.daru@dial.oleane.com <legouest.daru@dial.oleane.com>
authors.forename: J C
authors.initials: JC
authors.lastname: Favier
authors.forename: M
authors.initials: M
authors.lastname: Da Conceiçao
authors.forename: G
authors.initials: G
authors.lastname: Genco
authors.forename: I
authors.initials: I
authors.lastname: Bidallier
authors.forename: M
authors.initials: M
authors.lastname: Fassassi
authors.forename: T
authors.initials: T
authors.lastname: Steiner
authors.forename: R
authors.initials: R
authors.lastname: Pitti
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000191:economics; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000502:physiology; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000191:economics / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011292:Premedication; D011446:Prospective Studies; D000077149:Sevoflurane; D017409:Sufentanil
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D017409:Sufentanil
vernacular_title: Intubation fibroscopique sous sévoflurane chez l'adulte avec un masque facial endoscopique en cas d'intubation difficile.