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Abstract
There are no clear guidelines for the optimal method to secure the airway in patients with cervical spine injuries, with the exception that the head and neck must be kept in a neutral position throughout the intubation procedure, head and neck movement and stabilization of the spine during oral intubation are usually prevented by manual inline axial stabilizationMIAS Direct laryngoscope and fiberoptic bronchoscope were selected in the present study to intubate patients with cervical spine injury. Direct laryngoscopy is a faster mean to secure the airway than most other techniques, easy to be used with no special training, cheap, and available in all operative theatres. On the other hand flexible fiberoptic intubation is a fast and reliable technique with a very low failure rate, provided that the operator has all the equipments, training, and skills necessary to perform the technique In the present study we compared direct laryngoscopic and fiberoptic bronchoscopic intubation as regard difficulty (assessed by intubation difficulty score IDS), hemodynamic and respiratory changes and occurrence of cervical spine displacement as a complication of intubation We found that fiberoptic bronchoscope is superior to direct laryngoscope in management of patients with cervical spines injury as regard intubation difficulty and occurrence of complication as no cervical spines displacement occur with fiberoptic bronchoscope but respiratory parameters (oxygen saturation and end tidal CO2) was more stable in DL group, hemodynamic parameters affected by the same values in both groups.