The use of modified bite block to improve the safety and efficacy of oral fiber optic intubation in patients with limited neck mobility: a randomized comparative study

Background
One critical aspect of anesthesia is to provide airway management. Fiber optic intubation is the safest solution but can be difficult in patients with limited neck mobility. Insertion of the fiber optic bronchoscope through a modified bite block might facilitate intubation in such patients. Here, we performed fiber optic intubation without and with a bite block that was modified to compare the safety and efficacy of the two techniques.
Method
Sixty adult patients with limited neck mobility who were to undergo elective surgery with mandatory tracheal intubation under spontaneous ventilation were assigned to two groups. In group TR, the traditional technique of oral fiber optic intubation was performed without the use of a bite block. In group MB, the fiber optic was inserted through a modified bite block.
Results
Both groups showed statistically significant increases from baseline in mean arterial pressure and heart rate during the first 3 min after intubation; this increase was marked in the TR group than in the MB group. Hemoglobin oxygen saturation was significantly greater in the MB group than in the TR group. The time to successful intubation was significantly shorter in the MB group than in the TR group. The quality of intubation field shows a significant difference in value between MB and TR groups with the best result observed in MB.
Conclusion
Oral fiber optic intubation with a modified bite block performed under spontaneous ventilation is safer and more effective than traditional fiber optic intubation for patients with limited neck mobility.