Sedation vs. General Anesthesia in Fiberoptic-Assisted Intubation

Abstract

Fiberoptic-assisted intubation (FAI) is a crucial technique for managing difficult airways, particularly in patients with anatomical or clinical challenges. The decision between sedation and general anesthesia during FAI depends on various factors, including patient characteristics, procedural requirements, and clinician expertise. Sedation is advantageous in maintaining spontaneous ventilation and airway reflexes, making it suitable for awake intubation in cooperative patients with anticipated difficult airways. In contrast, general anesthesia ensures complete immobility and eliminates procedural discomfort, making it ideal for uncooperative patients or complex surgical cases. Both approaches have unique challenges, including airway compromise, hypoxia, and hemodynamic instability, necessitating careful monitoring and preparedness to manage complications. This systematic review evaluates the benefits, limitations, and clinical applications of both sedation and general anesthesia in FAI, offering evidence-based recommendations for optimal technique selection to enhance patient safety and procedural success.