Blind intubation device for nasotracheal intubation in 100 oral and maxillofacial surgery patients with anticipated difficult airways: a prospective evaluation.
OBJECTIVE
The blind intubation device is a newly developed light-guided intubation device for difficult nasotracheal intubation. The aim of this study was to evaluate its performance in adult patients with anticipated difficult airways.


METHODS
One hundred consecutive patients who required general anaesthesia with nasotracheal intubation for elective oral and maxillofacial surgery between March 2008 and August 2008 were recruited. In each case, the time for oesophagus airway successful placement, the attempts of the light-guiding catheter insertion into the trachea, the attempts of the endotracheal tube intubation over the light-guiding catheter and the time from the oesophagus airway placement to the completion of endotracheal intubation were recorded. The associated complications were also recorded.


RESULTS
Fifty-nine male and 41 female patients were studied. Each of the patients had at least temporomandibular joint ankylosis, maxillary and mandibular fracture, oral cancer, obstructive sleep apnoea syndrome, mandibular hypoplasia and micrognathia and cervical tumour. The oesophagus airway was directly inserted into the trachea in six patients. The placement of the oesophagus airway was successful in remaining 94 patients. The median (interquartile range) time for the oesophagus airway placement was 47 (25-178) s. The overall success rate of the light-guiding catheter insertion was 95.0%. The overall success rate of the ETT intubation over the light-guiding catheter was 95.0%. The median (interquartile range) time for complete tracheal intubation process was 194 (22-380) s. There was no episode of hypoxaemia during tracheal intubation. In 28 (29.5%) of our patients, there was a small amount of blood present in the tip of the oesophagus airways or around the inner wall of the endotracheal tubes. No serious epistaxis was found either.


CONCLUSIONS
We have demonstrated the safe and effective use of the blind intubation device in 100 adult patients with anticipated difficult airways. The overall success rates of the oesophagus airway placement, the light-guiding catheter insertion and nasotracheal intubation over the light-guiding catheter were really satisfied. This technique could improve the success of blind nasal intubation, especially in situations in which fibreoptic equipment was unavailable. However, further studies are still required.
Sun
Yu
Y
Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jiang
Hong
H
Zhu
Yesen
Y
Xu
Hui
H
Huang
Yan
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000628:therapy*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008029:Lighting / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D019647:Oral Surgical Procedures; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult