Study objective: To compare the Bullard laryngoscope (BL) with the flexible fiberoptic bronchoscope (FFB) in a cervical spine injury model, using inline stabilization.
Design: Randomized clinical trial.
Setting: Main operating room of a tertiary care hospital.
Patients: 50 adult, ASA physical status I, II, and III patients undergoing an elective general anesthetic.
Interventions: Each patient's trachea was intubated with both techniques. Cricoid pressure was applied to half of the study patients.
Measurements: The time for laryngoscopic view and the time to intubation were recorded for each technique. The effects of cricoid pressure on laryngoscopic view and intubation time were determined.
Main results: The times for laryngoscopy and intubation were longer in the FFB group than in the BL group (p < 0.004). There was a significantly lower success rate of laryngoscopy view in the FFB group in the presence of cricoid pressure (15 of 25 patients, or 60%) than either of the BL groups or the FFB no-cricoid pressure group.
Conclusions: The BL is more reliable, quicker, and more resistant to the effects of cricoid pressure than is the FFB.