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Stephan Marsch - One of the best experts on this subject based on the ideXlab platform.

  • teaching the use of Fiberoptic Intubation in anesthetized spontaneously breathing patients
    Anesthesia & Analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to <95% in two patients in Group B. Failure to pass the tube into the trachea over the bronchoscope was encountered in four patients in Group A and in no patient in Group B. Our data suggest that it is safe to teach the use of Fiberoptic Intubation in anesthetized, spontaneously breathing patients with normal airway anatomy. IMPLICATIONS Fiberoptic Intubation under spontaneous respiration is a well established technique for management of difficult airways. Our study demonstrates the feasibility and safety of a novice training program for Fiberoptic Intubation under general anesthesia, not only in paralyzed patients but also in those breathing spontaneously.

  • Teaching the Use of Fiberoptic Intubation in Anesthetized, Spontaneously Breathing Patients
    Anesthesia and analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to

  • Teaching the use of Fiberoptic Intubation for children older than two years of age.
    Anesthesia and analgesia, 1997
    Co-Authors: Thomas O Erb, K F Hampl, Stephan Marsch, Franz J. Frei
    Abstract:

    In 144 anesthetized children aged 2-9 yr, the safety and feasibility of orotracheal Fiberoptic Intubation, with and without an airway endoscopy mask, were assessed and compared with laryngoscopic Intubation. Eight anesthesia residents with experience in adult Fiberoptic Intubation, but who were beginners in pediatric anesthesia, participated in this study. In a randomized fashion, each resident intubated 18 children (6 in each group). The time (mean +/- SD) to achieve successful Intubation was different for laryngoscopic and Fiberoptic Intubation (34 +/- 17 s and 80 +/- 39 s, respectively; P 95% in all patients during conventional laryngoscopy and Fiberoptic laryngoscopy with a mask, whereas SpO2 decreased below 95% in 2 of the 48 patients during Fiberoptic Intubation without a mask. Both patients promptly recovered during ventilation via a face mask. We conclude that teaching the use of Fiberoptic Intubation in healthy, anesthetized children aged 2-9 yr is safe and feasible. Implications: Fiberoptic Intubation is a valuable technique of airway management. We studied the feasibility and safety of a training program that could be used for children more than 2 yr old. This study demonstrates that Fiberoptic Intubation can be effectively practiced in pediatric patients without increased risk of side effects. (Anesth Analg 1997;85:1037-41)

Thomas O Erb - One of the best experts on this subject based on the ideXlab platform.

  • teaching the use of Fiberoptic Intubation in anesthetized spontaneously breathing patients
    Anesthesia & Analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to <95% in two patients in Group B. Failure to pass the tube into the trachea over the bronchoscope was encountered in four patients in Group A and in no patient in Group B. Our data suggest that it is safe to teach the use of Fiberoptic Intubation in anesthetized, spontaneously breathing patients with normal airway anatomy. IMPLICATIONS Fiberoptic Intubation under spontaneous respiration is a well established technique for management of difficult airways. Our study demonstrates the feasibility and safety of a novice training program for Fiberoptic Intubation under general anesthesia, not only in paralyzed patients but also in those breathing spontaneously.

  • Teaching the Use of Fiberoptic Intubation in Anesthetized, Spontaneously Breathing Patients
    Anesthesia and analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to

  • Teaching the use of Fiberoptic Intubation for children older than two years of age.
    Anesthesia and analgesia, 1997
    Co-Authors: Thomas O Erb, K F Hampl, Stephan Marsch, Franz J. Frei
    Abstract:

    In 144 anesthetized children aged 2-9 yr, the safety and feasibility of orotracheal Fiberoptic Intubation, with and without an airway endoscopy mask, were assessed and compared with laryngoscopic Intubation. Eight anesthesia residents with experience in adult Fiberoptic Intubation, but who were beginners in pediatric anesthesia, participated in this study. In a randomized fashion, each resident intubated 18 children (6 in each group). The time (mean +/- SD) to achieve successful Intubation was different for laryngoscopic and Fiberoptic Intubation (34 +/- 17 s and 80 +/- 39 s, respectively; P 95% in all patients during conventional laryngoscopy and Fiberoptic laryngoscopy with a mask, whereas SpO2 decreased below 95% in 2 of the 48 patients during Fiberoptic Intubation without a mask. Both patients promptly recovered during ventilation via a face mask. We conclude that teaching the use of Fiberoptic Intubation in healthy, anesthetized children aged 2-9 yr is safe and feasible. Implications: Fiberoptic Intubation is a valuable technique of airway management. We studied the feasibility and safety of a training program that could be used for children more than 2 yr old. This study demonstrates that Fiberoptic Intubation can be effectively practiced in pediatric patients without increased risk of side effects. (Anesth Analg 1997;85:1037-41)

K F Hampl - One of the best experts on this subject based on the ideXlab platform.

  • teaching the use of Fiberoptic Intubation in anesthetized spontaneously breathing patients
    Anesthesia & Analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to <95% in two patients in Group B. Failure to pass the tube into the trachea over the bronchoscope was encountered in four patients in Group A and in no patient in Group B. Our data suggest that it is safe to teach the use of Fiberoptic Intubation in anesthetized, spontaneously breathing patients with normal airway anatomy. IMPLICATIONS Fiberoptic Intubation under spontaneous respiration is a well established technique for management of difficult airways. Our study demonstrates the feasibility and safety of a novice training program for Fiberoptic Intubation under general anesthesia, not only in paralyzed patients but also in those breathing spontaneously.

  • Teaching the Use of Fiberoptic Intubation in Anesthetized, Spontaneously Breathing Patients
    Anesthesia and analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to

  • Teaching the use of Fiberoptic Intubation for children older than two years of age.
    Anesthesia and analgesia, 1997
    Co-Authors: Thomas O Erb, K F Hampl, Stephan Marsch, Franz J. Frei
    Abstract:

    In 144 anesthetized children aged 2-9 yr, the safety and feasibility of orotracheal Fiberoptic Intubation, with and without an airway endoscopy mask, were assessed and compared with laryngoscopic Intubation. Eight anesthesia residents with experience in adult Fiberoptic Intubation, but who were beginners in pediatric anesthesia, participated in this study. In a randomized fashion, each resident intubated 18 children (6 in each group). The time (mean +/- SD) to achieve successful Intubation was different for laryngoscopic and Fiberoptic Intubation (34 +/- 17 s and 80 +/- 39 s, respectively; P 95% in all patients during conventional laryngoscopy and Fiberoptic laryngoscopy with a mask, whereas SpO2 decreased below 95% in 2 of the 48 patients during Fiberoptic Intubation without a mask. Both patients promptly recovered during ventilation via a face mask. We conclude that teaching the use of Fiberoptic Intubation in healthy, anesthetized children aged 2-9 yr is safe and feasible. Implications: Fiberoptic Intubation is a valuable technique of airway management. We studied the feasibility and safety of a training program that could be used for children more than 2 yr old. This study demonstrates that Fiberoptic Intubation can be effectively practiced in pediatric patients without increased risk of side effects. (Anesth Analg 1997;85:1037-41)

F. K. Pühringer - One of the best experts on this subject based on the ideXlab platform.

  • Use of remifentanil for awake Fiberoptic Intubation in a morbidly obese patient with severe inflammation of the neck
    Acta anaesthesiologica Scandinavica, 2002
    Co-Authors: W. Puchner, J. Obwegeser, F. K. Pühringer
    Abstract:

    Impending upper airway obstruction due to odontogenic facial and cervical spreading infection is a potential fatal situation that requires urgent treatment. In particular, securing the threatened airway is a priority and a precondition to the pressing need for surgery. The best approach to establish the difficult airway is awake Fiberoptic Intubation or scheduled tracheotomy under local anesthesia. We report a critical case of severe swelling of the neck in a morbidly obese patient with no alternative to awake Fiberoptic Intubation. The primary goals of optimal safety for the patient and appropriate intubating conditions for the anesthesiologist made us to consider a new method of patient medication.

  • Evaluation of remifentanil as single drug for awake Fiberoptic Intubation
    Acta anaesthesiologica Scandinavica, 2002
    Co-Authors: W. Puchner, J. Obwegeser, F. K. Pühringer, P Egger, A Lockinger, H Gombotz
    Abstract:

    Background:  Awake Fiberoptic Intubation is the standard of care for difficult airway management. Quality and success of this technique depend on the experience of the intubating physician and the proper preparation of the patient. The aim of this study was to compare remifentanil (R) as single agent to the combination of fentanyl (F) and midazolam (M), which have been the drugs for analgesia and sedation for this procedure. Methods:  Seventy-four adult patients requiring nasotracheal Intubation were randomly assigned to one of two groups. In group I, (n=37) R was administered in incremental dosages (0.1–0.25–0.5 µg/kg/min) by an infusion pump according to comfort, level of sedation and respiratory depression. In group II, (n=37) analgesia and sedation was achieved by F 1.5 µg/kg and doses of between 1 and 10 mg M, titrated to the individual needs. Patient reactions like grimacing, movement and coughing during Intubation were assessed, as well as patient recall of the procedure. Haemodynamic and respiratory parameters were continuously recorded. Results:  Group I patients better tolerated nasal tube passage (P

  • evaluation of remifentanil as single drug for awake Fiberoptic Intubation
    Acta Anaesthesiologica Scandinavica, 2002
    Co-Authors: W. Puchner, J. Obwegeser, F. K. Pühringer, P Egger, A Lockinger, H Gombotz
    Abstract:

    Background:  Awake Fiberoptic Intubation is the standard of care for difficult airway management. Quality and success of this technique depend on the experience of the intubating physician and the proper preparation of the patient. The aim of this study was to compare remifentanil (R) as single agent to the combination of fentanyl (F) and midazolam (M), which have been the drugs for analgesia and sedation for this procedure. Methods:  Seventy-four adult patients requiring nasotracheal Intubation were randomly assigned to one of two groups. In group I, (n=37) R was administered in incremental dosages (0.1–0.25–0.5 µg/kg/min) by an infusion pump according to comfort, level of sedation and respiratory depression. In group II, (n=37) analgesia and sedation was achieved by F 1.5 µg/kg and doses of between 1 and 10 mg M, titrated to the individual needs. Patient reactions like grimacing, movement and coughing during Intubation were assessed, as well as patient recall of the procedure. Haemodynamic and respiratory parameters were continuously recorded. Results:  Group I patients better tolerated nasal tube passage (P<0.001) and laryngeal tube advancement (P<0.001) than group II. Remifentanil better suppressed hemodynamic response to nasal Intubation (P<0.001). No significant difference in respiratory data was recorded. In group I more recall of the procedure was observed (six vs. zero patients, P<0.05). Conclusion:  Remifentanil in high doses, as the single agent for patient preparation for awake Fiberoptic Intubation seems to improve intubating conditions, quality and reliability of the procedure. However, a higher incidence of recall is to be expected.

C Kern - One of the best experts on this subject based on the ideXlab platform.

  • teaching the use of Fiberoptic Intubation in anesthetized spontaneously breathing patients
    Anesthesia & Analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to <95% in two patients in Group B. Failure to pass the tube into the trachea over the bronchoscope was encountered in four patients in Group A and in no patient in Group B. Our data suggest that it is safe to teach the use of Fiberoptic Intubation in anesthetized, spontaneously breathing patients with normal airway anatomy. IMPLICATIONS Fiberoptic Intubation under spontaneous respiration is a well established technique for management of difficult airways. Our study demonstrates the feasibility and safety of a novice training program for Fiberoptic Intubation under general anesthesia, not only in paralyzed patients but also in those breathing spontaneously.

  • Teaching the Use of Fiberoptic Intubation in Anesthetized, Spontaneously Breathing Patients
    Anesthesia and analgesia, 1999
    Co-Authors: Thomas O Erb, K F Hampl, Moritz Schurch, C Kern, Stephan Marsch
    Abstract:

    UNLABELLED In patients with difficult airways, the standard of care involves Fiberoptic Intubation under spontaneous ventilation. However, the safety and feasibility of a Fiberoptic Intubation teaching program has only been documented in paralyzed and apneic patients, whereas data obtained in patients under spontaneous respiration are limited and conflicting. We evaluated 100 anesthetized patients undergoing orotracheal Fiberoptic Intubation. Five anesthesia residents with no prior experience in Fiberoptic laryngoscopy participated in the study. In a randomized fashion, each participant tracheally intubated 10 spontaneously breathing patients (Group A: sevoflurane anesthesia via an airway endoscopy mask) and 10 paralyzed patients (Group B: total IV anesthesia with propofol, fentanyl, atracurium). Overall rate of success (96%), defined as successful Intubation of the trachea within two attempts, was not different between groups. During Fiberoptic Intubation, Spo2 values remained >95% in Group A, whereas Spo2 decreased to