title: [An awake fiberoptic intubation protocol: descriptive retrospective assessment of safety and efficacy].
abstract: OBJECTIVE
  Flexible fiberoptic intubation of the trachea is emphasized in guidelines on the management of difficult airway. The aim of this study was to analyze the efficacy and safety of our tertiary hospital's awake fiberoptic intubation protocol.
  
  
  METHODS
  For retrospective descriptive study we collected information on all fiberoptic intubations performed on awake patients in the 3 years after a specific protocol was implemented. The protocol's key points focus on operating room arrangement, required staff, and sedation before the procedure. Data gathered included demographic variables, patients' diseases, preanesthetic assessment of potential difficult airway, adherence to the protocol, medication administered, and complications recorded.
  
  
  RESULTS
  In the course of the study, 634 fiberoptic intubations were performed; 473 patients (74.6%) had at least 1 risk factor for aspiration and 232 patients (36.5%) had at least 1 type of cardiovascular comorbidity. Difficult intubation was expected in 67%. In 99%, remifentanil was administered via target controlled infusion with a mean effect concentration of 2.9 ng/mL. The operating room arrangement and staffing protocol was followed in all cases. No pulmonary or hemodynamic complications occurred during fiberoptic intubation or immediately after surgery.
  
  
  CONCLUSIONS
  Our hospital's protocol was followed in all cases and no post-implementation complications were detected.
authors.affiliation: Servicio de Anestesiología y Reanimación, Clínica Universidad de Navarra, Pamplona. mjyepes@unav.es
authors.forename: M J
authors.initials: MJ
authors.lastname: Yepes Temiño
authors.forename: A
authors.initials: A
authors.lastname: Panadero Sánchez
authors.forename: R
authors.initials: R
authors.lastname: Callejas González
authors.forename: F
authors.initials: F
authors.lastname: Carrascosa Moreno
authors.forename: J R
authors.initials: JR
authors.lastname: Pérez Valdivieso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult