Two different approaches of nasal tracheal intubation to anesthesia

Objective:To assess the feasibility of sedation via awake blind nasal tracheal intubation by partial pressure of end-tidal carbon dioxide(PETCO2) monitoring for patients with ankylosing spondylitis that leads to difficult airway intubation.Methods:Thirty ASA Ⅱ patients of ankylosing spondylitis(20 males,10 females;aged 40~80 years;weighing 55~70 kg)undergoing general anesthesia were randomized into groups of blind nasal intubation(group B,n=15) and fiberoptic bronchoscope guidance(FOB,n=15).All patients,who fell into grade Ⅲ~Ⅳ as the classification of difficulty in intubation defined by Cormack and Lehane,with mouth opening less than 2 cm,were undergone awake nasal tracheal intubation,and the two groups of patient were kept concerning the respective changes of mean arterial blood pressure(MAP),heart rate(HR) and SpO2 right after the intubation(T0),at 1 min(T1),5 min(T2),10 min(T3) and the moment of extubation(T4) besides duration of intubation,successful rate and complications.Results:Intubation was performed successfully in the total 30 patients.Nevertheless,group B consumed longer time in intubation than did of group FOB(P0.05),and significant differences of the two groups was found regarding the variation of MAP and HR at T1,T2,T3,T4 as compared with T0(P0.05).There was no significant difference concerning the rate of successful intubation and complications.Conclusion:Sedation via awake blind nasal tracheal intubation by partial pressure of end-tidal carbon dioxide(PETCO2) monitoring is safe and reliable for patients with difficult airway intubation due to ankylosing spondylitis.