A comparison of the Bullard laryngoscope versus the flexible fiberoptic bronchoscope during intubation in patients afforded Inline stabilization

Study Objective: To compare the Bullard laryngoscope (BL) with flexible fib eroptic bronchoscope (FFB) in a cervical spine injury model, using inline s tabilization. Design: Randomized clinical trial. Setting: Main operating room of a tertiary care hospital. Patients: 50 adult, ASA physical status I, II, and III patients undergoing an elective general anesthetic. Interventions: Each patient's trachea was intubated with both techniques. C ricoid pressure was applied to half of the study Patients Measurements: The time for laryngoscopic view and the time to intubation we re recorded for each technique. The effects of cricoid pressure on laryngos copic view and intubation time were determined. Main results: The times for laryngoscopy and intubation were longer in the FFB group than in the BI, group (p < 0.004). There was a significantly lowe r success rate of laryngoscopy view in the FFB group in the presence of cri coid pressure (15 of 25 patients, or 60%) than either of the BL groups or t he FFB no-cricoid pressure group. Conclusions: The BL is more,reliable, quicker, and more resistant to the ef fects of cricoid pressure than is the FFB. (C) 2001 by Elsevier Science Inc .