Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 201 207 EN Atabak Najafi Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Eiman Rahimi Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Shariat Moharari Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zahid Hussain Khan Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 To compare intubating conditions and hemodynamic changes between Bonfils Intubation Fiberscope and Macintosh laryngoscopy without administering neuromuscular blocking drugs (NMBDs). METHODS: In this randomized controlled trial,80 male and female patients, scheduled for elective surgery, aged 15 to 60 years, ASA class II or I, non-obese, non smokers, without anticipated difficult intubation; were randomly allocated into two groups of 40: Bonfils and Macintosh. Following adequate hydration and preoxygenation, midazolam 0.03 mg.kg-1 was administered, followed by intravenous alfentanil 20 µg.kg-1, lidocaine 1.0 mg.kg-1, and propofol 2 mg.kg-1 sequentially. Trachea was then intubated using Bonfils Intubation Fiberscope in the Bonfils group and conventional Macintosh laryngoscopy in the Macintosh group. Intubating condition, mean arterial blood pressure, heart rate, pulse oximetry, and success rate were measured. RESULTS: Clinically acceptable intubating condition scores did not differ significantly between the groups (P=0.465). Compared to the baseline values, heart rate rose significantly after intubation only in the Macintosh group (P<0.001). Although mean arterial blood pressure increased immediately after intubation in the Macintosh group (P=0.022), its post-intubation values were significantly less than baseline in both groups (P<0.001). Intubation time took much longer in the Bonfils group (40 s) than the Macintosh group (11 s), P<0.001. In the absence of NMBDs, Bonfils Intubation Fiberscope compares well with Macintosh laryngoscopy in terms of success rate and intubating conditions, but with less mechanical stress and hemodynamic compromise and longer intubation time. https://acta.tums.ac.ir/index.php/acta/article/view/3724 https://acta.tums.ac.ir/index.php/acta/article/download/3724/3699