Practical Fibreoptic Intubation

Abstract

Practical Fibreoptic Intubation Mansukh Popat, MBBS, FRCA Boston: Butterworth Heinmann, 2001. ISBN 0-7506-4496-6. 191 pp, $63.00. Practical Fibreoptic Intubation, a synopsis of flexible fiberoptic intubation in 191 pages, is a small paperback book that fits easily into lockers or backpacks. The table of contents outlines major topics in airway endoscopy. Chapter 1 traces historic developments, fiberscope anatomy, the physics of light transmission, care and maintenance, cleaning and sterilizing, and the variety of scopes commercially available. Chapters 2 through 11 are infused with clinical pearls that could only have been written by an author with considerable experience in flexible fiberoptic endoscopy. These chapters make good reading for novice endoscopists. Discussions of training, indications, contraindications, aides/adjuncts, tracheal tube size, oral versus nasal route, and airway anesthesia provide important insights. Some issues deserve more attention they are afforded in these pages. The debate over informed consent hampers application and teaching flexible fiberoptic intubation. Further discussion might help the reader come to grips with this question. Target-controlled infusion (TCI) is mentioned in places, but TCI is unfamiliar to many people. The book does fall short in some ways. The diagram on page 121 shows a label reading “Superior cornu” without a line indicating its location on the diagram. The photograph on page 124 gives the impression that proper needle/catheter placement for translaryngeal anesthesia is directed cephalad, where it might encounter vocal cords. I prefer placing the needle perpendicular to the skin in all planes, if not slightly caudad. Dr. Popat does offer excellent insights into selection of flexible fiberoptic intubation, repeat attempts at traditional rigid laryngoscopy, airway anesthesia for full stomach patients, and sedation for awake intubation. Like an Agatha Christie novel, this book from across the pond gets more interesting as it progresses. It covers much the same information as Ovassapian’s monograph on flexible fiberoptic intubation, but does so in the author’s own way. The book should serve as a primer for novice endoscopists. However, at $63.00 a copy, neophyte endoscopists may want to share the book rather than purchase it. Allan P. Reed, MD Mount Sinai School of Medicine of New York University New York, NY