Buscar en
Revista Colombiana de Anestesiología
Toda la web
Inicio Revista Colombiana de Anestesiología Intubación con paciente despierto con fibroscopio retromolar de Bonfils bajo se...
Journal Information
Vol. 37. Issue 1.
Pages 49-56 (February - April 2009)
Share
Share
Download PDF
More article options
Vol. 37. Issue 1.
Pages 49-56 (February - April 2009)
SERIE DE CASOS
Open Access
Intubación con paciente despierto con fibroscopio retromolar de Bonfils bajo sedación con dexmedetomidina Reporte de 7 casos
Visits
3858
R. Fritz E. Gempeler
, M. Angélica Devis**, M. Pompilio A. Pedraza***
* Profesor Asociado Facultad de Medicina Pontificia Universidad Javeriana – Anestesiólogo Hospital Universitario de San Ignacio - Clínica del Country - Bogotá Colombia.
** Profesor Asistente Facultad de Medicina Universidad del Rosario – Anestesióloga Clínica del Country - Bogotá Colombia
*** Profesor Asistente Facultad de Medicina Pontificia Universidad Javeriana – Anestesiólogo Hospital Universitario de San Ignacio - Bogotá Colombia
This item has received

Under a Creative Commons license
Article information
RESUME

Diversas guías de manejo y algoritmos para el manejo y control de la vía aérea difícil recomiendan la intubación con el paciente despierto, como un método seguro. En los últimos años la intubación en paciente despierto se ha realizado con fibroscopio flexible o mediante laringoscopia clásica y directa . Últimamente se han desarrollado múltiples dispositivos; entre dichos estiletes se destaca el fibroscopio retromolar de Bonfils; este es un instrumento óptico semi-rígido en una curva anterior de 40 grados. Al acomodarlo dentro de un tubo endotraqueal y pasarlo por la vía aérea superior, es posible dirigirlo bajo visión directa a la glotis.

Se presentan en esta serie 7, casos de intubación en pacientes con vía aérea complicada, bajo sedación con dexmedetomidina con fibroscopia retromolar de Bonfils, sin aplicación de anestesia tópica.

Palabras claves:
Fibroscopio retromolar
intubación
paciente despierto
SUMMARY

Acording to the “Practice Guidelines for management of a difficult airway”, and several algorithnes, an awake intubation is considered the first method to secure a suspected difficult airway. During last years the awake intubation was performed by flexible fiberoptic laringoscopy or with a rigid stylet. Within the last decade, many new devices have been developed to assist anesthesiologist with both routine and difficult airway management, one of wich is the Bonfils Retromolar Intubacion Fiberscope. It is a semi-rigid optical stylet 40 cm long of 5,0 external diameter and a tip curvature of 40 degrees; the adult stylet can accommodate a 6,5 mm endotracheal tube and sliding it in the superior airway, it is possible to entubate the glottis under direct vision. We present seven case report with difficult airway, managed with dexmedotomidine using the Bonfils retromolar fiberscope without topical anesthetic.

Key works:
retromolar fiberscopy
entubation
awake patient
Full text is only aviable in PDF
REFERENCIAS
[1.]
American Society of Anesthesiologists Task Force on Management of the Difficult Airway.
Practice guidelines for management of the difficult airway: an updated report by the American society of anesthesiologists task force on management of the difficult airway.
Anesthesiology, 98 (2003), pp. 1269-1277
[2.]
E.B. Liem, D.G. Bjoraker, D. Gravenstein.
New options for airway management: intubating fibreoptic stylets.
Br J Anaesth, 91 (2003), pp. 408-418
[3.]
C.A. Hagberg.
Special devices and techniques.
Anesthesiol Clin North America, 20 (2002), pp. 907
[4.]
U. Buehner, J. Oram, S. Elliot, A. Mallick, A. Bodenham.
Bonfils semirigid endoscope for guidance during percutaneous tracheostomy.
Anaesthesia, 61 (2006), pp. 665-670
[5.]
C. Rudolph, M. Schlender.
Clinical experiences with fiber optic intubation with the Bonfils intubation fiberscope.
Anaesthesiol Reanim, 21 (1996), pp. 127-130
[6.]
M. Halligan, P. Charters.
A clinical evaluation of the Bonfils intubation fibrescope.
Anaesthesia, 58 (2003), pp. 1087-1091
[7.]
B. Bein, F. Worthmann, J. Scholz, F. Brinkmann, P.H. Tonner, M. Steinfath, V. Do"rges.
A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways.
Anaesthesia, 59 (2004), pp. 668-674
[8.]
S.I. Abramson, A.A. Holmes, C.A. Hagberg.
Awake Insertion of the Bonfils Retromolar Intubation Fiberscope™ in Five Patients with Anticipated Difficult Airways.
Anesth Analg, 106 (2008), pp. 1215-1217
[9.]
D.S. Carollo, B.D. Nossaman, U. Ramadhyani.
Dexmedetomidine a review of clinical applications.
Current Opinion in Anesthesiology, 21 (2008), pp. 457-461
[10.]
S.A. Grant, D.S. Breslin, D.V. MacLeod, D. Gleason, G.J. Martin.
Dexmedetomidine Infusion for Sedation During Fiberoptic Intubation A Report of Three Cases.
Clin Anesth, 16 (2004), pp. 124-126
[11.]
B.M. Wahlen, E. Gercek.
Three-dimensional cervical spine movement during intubation using the Macintosh and Bullard laryngoscopes, the Bonfils fibrescope and the intubating laryngeal mask airway.
Eur J Anaesthesiol, 21 (2004), pp. 907-913
[12.]
C. Rudolph, J.P. Schneider, Wallenborn, L. Schaffranietz.
Movement of the upper cervical spine during laryngoscopy: a comparison of the Bonfils intubation fibrescope and the Macintosh laryngoscope.
Anaesthesia, 60 (2005), pp. 668-672
[13.]
A. Ovassapian.
The flexible bronchoscope: a tool for anesthesiologists.
Clin Chest Med, 22 (2001), pp. 281-299
Copyright © 2009. Revista Colombiana de Anestesiología
Article options
Tools