Fibre-optic intubation, including local anaesthesia for awake intubation

Airway problems are a major concern to anaesthetists; however, the introduction of fibre-optic intubation and awake fibre-optic intubation have revolutionized the anaesthetic management of the difficult airway. To perform fibre-optic intubation it is essential to have a basic understanding of the equipment, how to use it and how to prepare and maintain the airway for intubation under local or general anaesthetic. Effective endoscopy requires a good view, skilful manipulation of the instrument and a thorough understanding of airway anatomy. Careful handling of the endoscope and effective cleaning are essential for patient safety and to preserve the life of the equipment. Steps must be taken to ensure effective decontamination and to prevent recontamination before use.