University Medical Center of the Johannes Gutenberg-University, Department of Anaesthesiology, Mainz, Germany.
Scand J Trauma Resusc Emerg Med. 2009 Jul 22;17:33. doi: 10.1186/1757-7241-17-33.
The Bonfils intubation fibrescope is a promising alternative device for securing the airway. We examined the success rate of intubation and the ease of use in standardized simulated difficult airway scenarios by physicians. We compared the Bonfils to a classical laryngoscope with Macintosh blade.
30 physicians untrained in the use of rigid fibrescopes but experienced in airway management performed endotracheal intubation in an airway manikin (SimMan, Laerdal, Kent, UK) with three different airway conditions. We evaluated the success rate using the Bonfils (Karl Storz, Tuttlingen, Germany) or the Macintosh laryngoscope, the time needed for securing the airway, and subjective rating of both techniques.
In normal airway all intubations were successful using laryngoscope (100%) vs. 82% using the Bonfils (p < 0.05). In the scenario "tongue oedema" success rate using the Macintosh laryngoscope was 67% and 83% using the Bonfils. In the scenario "decreased cervical range of motion with jaw trismus", success rate using the Macintosh laryngoscope was 84% vs. 76%. In difficult airway scenarios time until airway was secured did not differ between the two devices. Use of Bonfils was rated "easier" in both difficult airway scenarios.
The Bonfils can be successfully used by physicians unfamiliar with this technique in an airway manikin. The airway could be secured with at least the same success rate as using a Macintosh laryngoscope in difficult airway scenarios. Use of the Bonfils did not delay intubation in the presence of a difficult airway. These results indicate that intensive special training is advised to use the Bonfils effectively in airway management.
Bonfils 插管纤维镜是一种有前途的气道安全替代设备。我们检查了医师在标准化模拟困难气道场景中插管的成功率和易用性。我们将 Bonfils 与经典的 Macintosh 叶片喉镜进行了比较。
30 名未经刚性纤维镜使用培训但具有气道管理经验的医师在气道模拟人（SimMan，Laerdal，Kent，英国）中进行了三种不同气道条件下的气管内插管。我们使用 Bonfils（Karl Storz，Tuttlingen，德国）或 Macintosh 喉镜评估插管成功率、气道固定所需时间以及两种技术的主观评分。
在正常气道中，喉镜（100%）与 Bonfils（82%）的插管成功率均为 100%（p<0.05）。在“舌肿胀”的情况下，Macintosh 喉镜的成功率为 67%，Bonfils 的成功率为 83%。在“颈椎活动度降低伴下颌紧闭”的情况下，Macintosh 喉镜的成功率为 84%，Bonfils 的成功率为 76%。在困难气道情况下，两种设备的气道固定时间无差异。在两种困难气道情况下，使用 Bonfils 的评分均为“更简单”。
不熟悉该技术的医师可以在气道模拟人上成功使用 Bonfils。在困难气道情况下，至少可以与 Macintosh 喉镜一样成功地固定气道。在存在困难气道的情况下，使用 Bonfils 不会延迟插管。这些结果表明，建议进行强化特殊培训，以便在气道管理中有效地使用 Bonfils。
