{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,15]],"date-time":"2026-11-15T06:38:26Z","timestamp":1794724706091,"version":"4.9.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology"],"published-print":{"date-parts":[[2007,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tracheal intubation with neuromuscular blocking agents is associated with a low incidence of minor vocal cord sequelae (8%). The aim of this noninferiority trial was to demonstrate that the frequency of vocal cord sequelae after fiberoptic intubation with a flexible silicone tube without neuromuscular blocking agents was less than 25% (maximum tolerable inferiority).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two-hundred seventy patients were prospectively randomized to two groups. All intubations were performed by anesthesiologists with extensive experience in fiberoptic and conventional techniques. Fiberoptic nasotracheal intubation consisted of a bolus dose of 2 microg\/kg fentanyl; 0.25 ml cocaine instillation, 10%, into nasal canals; cricothyroid injection of 2 ml lidocaine, 1%; bronchoscopy; administration of 0.3 mg\/kg etomidate; and advancing a flexible silicone tube after loss of consciousness. Orotracheal intubation was performed with a polyvinyl chloride tube after induction with 2 microg\/kg fentanyl, 2 mg\/kg propofol, and 0.6 mg\/kg rocuronium. Patients were examined by laryngoscopy before surgery, 24 h after surgery, and daily until complete restitution. Postoperative hoarseness was assessed by a standardized interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of vocal cord sequelae was 11 out of 130 (8.5%) in the fiberoptic group versus 12 out of 129 (9.3%) in the control group (chi-square = 0.057, df = 1, P = 0.81; upper limit of the one-sided 95% confidence interval for the difference: +5.1%). There were no persistent injuries. The incidence of postoperative hoarseness was 4% in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Because fiberoptic intubation without neuromuscular blocking agents is safe regarding vocal cord sequelae, routine use is justified for anesthesiologists experienced in this technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/01.anes.0000281925.61143.b5","type":"journal-article","created":{"date-parts":[[2009,3,4]],"date-time":"2009-03-04T17:47:33Z","timestamp":1236188853000},"page":"585-590","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":22,"title":["Fiberoptic Intubation and Laryngeal Morbidity"],"prefix":"10.1097","volume":"107","author":[{"given":"Thomas","family":"Heidegger","sequence":"first","affiliation":[{"name":"Associate Professor and Head, Department of Anaesthesia, Spitalregion Rheintal Werdenberg Sarganserland, Walenstadt, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Starzyk","sequence":"additional","affiliation":[{"name":"Resident."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia\u00a0R.","family":"Villiger","sequence":"additional","affiliation":[{"name":"Staff."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schumacher","sequence":"additional","affiliation":[{"name":"Staff, Department of Ear, Nose, Throat, and Neck Surgery, Cantonal Hospital St. Gallen."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Studer","sequence":"additional","affiliation":[{"name":"Staff, Department of Ear, Nose, Throat, and Neck Surgery, Cantonal Hospital St. Gallen."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Peter","sequence":"additional","affiliation":[{"name":"Staff, Department of Ear, Nose, Throat, and Neck Surgery, Cantonal Hospital St. Gallen."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Nuebling","sequence":"additional","affiliation":[{"name":"Empirical Consulting, Denzlingen, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u00a0J.","family":"Gerig","sequence":"additional","affiliation":[{"name":"Deputy Head."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas\u00a0W.","family":"Schnider","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Anaesthesiology."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-13-20251016"},{"key":"R2-13-20251016"},{"key":"R3-13-20251016"},{"key":"R4-13-20251016"},{"key":"R5-13-20251016"},{"key":"R6-13-20251016"},{"key":"R7-13-20251016"},{"key":"R9-13-20251016"},{"key":"R10-13-20251016"},{"key":"R11-13-20251016"},{"key":"R12-13-20251016"},{"key":"R13-13-20251016"},{"key":"R15-13-20251016"},{"key":"R16-13-20251016"},{"key":"R17-13-20251016"},{"key":"R18-13-20251016"},{"key":"R19-13-20251016"},{"key":"R20-13-20251016"},{"key":"R21-13-20251016"},{"key":"R22-13-20251016"},{"key":"R23-13-20251016"},{"key":"R24-13-20251016"},{"key":"R25-13-20251016"},{"key":"R26-13-20251016"},{"key":"R27-13-20251016"},{"key":"R28-13-20251016"},{"key":"R29-13-20251016"},{"key":"R30-13-20251016"}],"container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/107\/4\/585\/655222\/0000542-200710000-00013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.lww.com\/00000542-200710000-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T18:00:25Z","timestamp":1760637625000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000542-200710000-00012"}},"subtitle":["A Randomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2007,10,1]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2007]]}},"URL":"https:\/\/doi.org\/10.1097\/01.anes.0000281925.61143.b5","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1097130.553113","asserted-by":"object"}]},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2007,10,1]]}}}