title: Evaluation of Endotracheal Intubation with a Flexible Fiberoptic Bronchoscope in Lateral Patient Positioning: A Prospective Randomized Controlled Trial.
abstract: BACKGROUND
  There is an unmet need for a reliable method of airway management for patients in the lateral position. This prospective randomized controlled two-center study was designed to evaluate the feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery.
  
  
  METHODS
  Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April 1, 2015, to September 30, 2015, were enrolled in this study. Patients were randomly assigned to the supine position group (Group S, n = 38) and the lateral position group (Group L, n = 34). Experienced anesthetists performed tracheal intubation with a fiberoptic bronchoscope after general anesthesia. The time required for intubation, intubation success rates, and hemodynamic changes was recorded. Between-group differences were assessed using the Student's t-test, Mann-Whitney U-test, or Chi-square test.
  
  
  RESULTS
  The median total time to tracheal intubation was significantly longer in Group S (140.0 [135.8, 150.0] s) compared to Group L (33.0 [24.0, 38.8] s) (P < 0.01). The first-attempt intubation success rate was significantly higher in Group L (97%) compared to Group S (16%). Hemodynamic changes immediately after intubation were more exaggerated in Group S compared to Group L (P = 0.02).
  
  
  CONCLUSIONS
  Endotracheal intubation with a flexible fiberoptic bronchoscope may be an effective and timesaving technique for patients in the lateral position.
  
  
  BACKGROUND
  Chinese Clinical Trial Register, ChiCTR-IIR-16007814; http://www.chictr.org.cn/showproj.aspx?proj=13183.
authors: Department of Anesthesiology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310003, China.
authors: Hui
authors: H
authors: Li
authors: Department of Anesthesiology, Lishui Central Hospital of Zhejiang Province, Lishui, Zhejiang 323000, China.
authors: Wu
authors: W
authors: Wang
authors: Department of Anesthesiology, Jiaxing First Hospital of Zhejiang Province, Jiaxing, Zhejiang 314001, China.
authors: Ya-Ping
authors: YP
authors: Lu
authors: Department of Anesthesiology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310003, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Gastroenterology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310003, China.
authors: Li-Hua
authors: LH
authors: Chen
authors: Department of Anesthesiology, Lishui Central Hospital of Zhejiang Province, Lishui, Zhejiang 323000, China.
authors: Li-Pei
authors: LP
authors: Lei
authors: Department of Anesthesiology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310003, China.
authors: Xiang-Ming
authors: XM
authors: Fang
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management; D020680:Bronchoscopes; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011446:Prospective Studies; D055815:Young Adult