[Clinical observation of Cookgas intubating laryngeal airway in anticipating difficult tracheal intubation].
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.
Yang
Dong
D
Department of Anesthesiology, Plastic Surgery Hospital, CAMS and PUMC, Beijing 100041, China.
Deng
Xiao-Ming
XM
Luo
Mao-Ping
MP
Wei
Ling-Xin
LX
Sui
Jing-Hu
JH
Liao
Xu
X
Zhang
Yan-Ming
YM
Xu
Kun-Lin
KL
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