ArticleJournal of anesthesia2026
Efficacy of inserting a flexible bronchoscope to a predetermined depth for orotracheal intubation by inexperienced personnel: a randomized-controlled study.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeBronchoscopic tracheal intubation is an indispensable technique in patients with difficult airway, but it is often difficult, particularly for less-experienced anesthesiologists, to obtain a view of the glottis by bronchoscopy. We hypothesized that insertion of a flexible bronchoscope to a predetermined depth would facilitate bronchoscopic intubation.
methodsFifty anesthetized patients were randomly allocated to two groups, and inexperienced anesthesiologists either inserted a bronchoscope along the center of the tongue (in group C), or along the hard palate to a predetermined depth based on the mouth-to-tragus distance (in group S). The success rate of obtaining a bronchoscopic view of the glottis (primary outcome) and other factors were compared.
resultsThe success rate of obtaining a bronchoscopic view of the glottis was significantly higher in group S (24 of 25 patients) than in group C (17 of 25 patients) (P = 0.02; 95%CI for difference: 8 - 48%]). The success rate of tracheal intubation was significantly higher in group S (18 of 25 patients) than in group C (8 of 25) (P = 0.01). Time to glottic visualization was significantly shorter in group S (24 [14 - 40] s) than in group C (49 [30 - 120]] s) (P = 0.003), and apnea time was significantly shorter in group S (81 [52 - 120] s) than in group C (120 [109 - 120] s) (P = 0.004).
conclusionsInsertion of a bronchoscope for the mouth-to-tragus distance would increase the success rate of bronchoscopic intubation, by facilitating to obtain a bronchoscopic view of the glottis. CLINICAL
trial registrationjRCT1032250593.
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