title: [Clinical observation of Cookgas intubating laryngeal airway in anticipating difficult tracheal intubation].
abstract: OBJECTIVE
  To compare the clinical effects of Cookgas intubating laryngeal airway (CILA) in facilitating fiberoptic bronchoscope (FOB) and Shikani optical stylet (SOS)-guided intubations in anticipating difficult tracheal intubation.
  
  
  METHODS
  Totally 60 anticipated difficult tracheal intubation patients undergoing selective plastic surgery under general anesthesia were allocated to FOB group (n = 30) and SOS group (n = 30). After anesthesia induction and CILA insertion, the patients were treated with FOB or SOS-guided intubation via CILA. The time of intubation and CILA removal and the time and the success rate of CILA insertion were recorded. Noninvasive blood pressure and heart rate were recorded before and after anesthesia induction at CILA insertion, at intubation, at CILA removal, and every minute thereafter for 5 minutes.
  
  
  RESULTS
  CILA was inserted successfully in all patients. The first intubation attempt succeeded in all but two who succeeded in the second and the third attempt respectively in FOB group. In SOS group, 18 patients were successfully intubated in the first attempt, and 7 patients were successfully intubated in the second attempt; SOS failed in 5 patients with severe cervical scars, and then FOB was successfully used to intubate. The time of the intubation [(60.2 +/- 29.6) vs. (92.4 +/- 47.9)s] and CILA removal [(104.6 +/- 39.9) vs. (130.0 +/- 51.9) s] in SOS group were significantly longer than in FOB group (P < 0.05). Hemodynamic changes during the intubation with CILA in these two groups were minimal.
  
  
  CONCLUSIONS
  FOB and SOS-guided tracheal intubation via CILA is safe and effective in anticipating the outcome of difficult airway management. Compare to SOS-guided intubation, the time of FOB-guided intubation is shorter and the success rate is higher.
authors.affiliation: Department of Anesthesiology, Plastic Surgery Hospital, CAMS and PUMC, Beijing 100041, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yang
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Deng
authors.forename: Mao-Ping
authors.initials: MP
authors.lastname: Luo
authors.forename: Ling-Xin
authors.initials: LX
authors.lastname: Wei
authors.forename: Jing-Hu
authors.initials: JH
authors.lastname: Sui
authors.forename: Xu
authors.initials: X
authors.lastname: Liao
authors.forename: Yan-Ming
authors.initials: YM
authors.lastname: Zhang
authors.forename: Kun-Lin
authors.initials: KL
authors.lastname: Xu
mesh_terms: D000768:Anesthesia, General; D020680:Bronchoscopes; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D019370:Observation; D013518:Surgery, Plastic; D013647:Task Performance and Analysis; D016896:Treatment Outcome