title: Comparison of two different techniques of fibreoptic intubation.
abstract: OBJECTIVE
  The application of analgesics and sedatives during fibreoptic intubation (FOI) may result in a transient decrease in arterial oxygen saturation.This study evaluates two different techniques of FOI and respective effects on procedural duration, arterial oxygen saturation, and coughing by the patient.
  
  
  METHODS
  Thirty-four patients received a standardized conscious sedation with fentanyl (1.5 microg kg(-1)) and midazolam (12.5 microg kg(-1)).All patients were randomly allocated to one of the following techniques: the 'vaporization' (VAP) technique included four applications of 2 ml lidocaine 2% administered through the working channel of the fibrescope supplying an oxygen flow of 3 l min(-1); the 'standard' (STAN) technique included the insufflation of 3 l(-1) min oxygen via a nasal probe and two applications of 4 ml of lidocaine 2%, each followed by a maximum of 2 min to take effect.
  
  
  RESULTS
  FOI was successful in all patients (STAN 15; 'vaporization' 17 patients). The overall intubation time interval was significantly (P < 0.001) shorter in the VAP group. There was no difference in oxygen saturation between the two groups prior to the start of FOI, but a significant (P = 0.008) decrease in oxygen saturation levels was detected in the STAN group after completion of FOI. Patients in the VAP group coughed less; a significant difference in the number of coughs (P = 0.036) was found during the application of lidocaine into the proximal trachea.
  
  
  CONCLUSIONS
  The VAP technique decreases overall intubation time, increases the oxygen saturation of the patient until completion of the intubation, and reduces cough.
authors.affiliation: Department of Anaesthesiology, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Piepho
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Thierbach
authors.forename: Susanne M
authors.initials: SM
authors.lastname: Göbler
authors.forename: Marc O
authors.initials: MO
authors.lastname: Maybauer
authors.forename: Christian
authors.initials: C
authors.lastname: Werner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D016292:Procedural Sedation; D003371:Cough / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen