Yang Dong, Deng Xiao-Ming, Luo Mao-Ping, Wei Ling-Xin, Sui Jing-Hu, Liao Xu, Zhang Yan-Ming, Xu Kun-Lin
Department of Anesthesiology, Plastic Surgery Hospital, CAMS and PUMC, Beijing 100041, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Dec;29(6):755-9.
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.
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.
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.
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.
比较库克气体插管喉罩（CILA）在预计困难气管插管时辅助纤维支气管镜（FOB）和希卡尼光导硬杆喉镜（SOS）引导插管的临床效果。
将60例预计困难气管插管且行择期整形手术的全身麻醉患者分为FOB组（n = 30）和SOS组（n = 30）。麻醉诱导并插入CILA后，患者通过CILA接受FOB或SOS引导插管。记录插管及拔除CILA的时间、插入CILA的时间及成功率。记录麻醉诱导前、插入CILA时、插管时、拔除CILA时及此后5分钟内每分钟的无创血压和心率。
所有患者CILA均成功插入。FOB组除2例分别在第二次和第三次尝试成功外，首次插管尝试均成功。SOS组18例患者首次尝试成功插管，7例患者第二次尝试成功插管；5例严重颈部瘢痕患者SOS插管失败，随后FOB成功用于插管。SOS组的插管时间[（60.2±29.6） vs. （92.4±47.9）s]和拔除CILA的时间[（104.6±39.9） vs. （130.0±51.9）s]均显著长于FOB组（P < 0.05）。两组使用CILA插管期间的血流动力学变化均最小。
通过CILA进行FOB和SOS引导气管插管在预测困难气道处理结果方面安全有效。与SOS引导插管相比，FOB引导插管时间更短，成功率更高。
