Application of orotracheal intubation using blind tracheal intubation device in difficult airway patients receiving nasal plastic surgery

Objective To assess the clinical value of the blind intubation device in difficult airway patients receiving nasal plastic surgery by comparing the effects of the blind intubation device with fibreoptic bronchoscope for awake orotracheal intubation.Methods Sixty difficult airway patients who were to receive nasal plastic surgery were divided into two groups(n=30).Group Ⅰ received awake orotracheal intubation with the blind intubation device;Group Ⅱ received fibreoptic bronchoscope for awake orotracheal intubation.The success rates,time of intubation,the changes of circulation and respiration,and complications were all observed in two groups.Results The success rate was 100%(30/30)in group Ⅰ and 93.3%(28/30)in group Ⅱ.The reason for the two unsuccessful cases was the small oral opening which preventing placement of the protective bite-block to avoid damage of bronchoscope stem.Finally,the two cases were successfully intubated using the blind intubation device technique.The mean time of intubation was(4.1±1.3)min in group Ⅰ and(3.8±1.2)min in group Ⅱ,with no significant difference found between the two groups(P0.05).The heart rate(HR)and mean arterial pressure(MAP)were(72±8)/min and(87±9)mmHg(1 mmHg=0.133 kPa)in group Ⅰ before intubation,which were significantly lower than those after intubation([90±10]/min and [104±12] mmHg,all P0.05).The HR and MAP were(75±10)/min and(88±7)mmHg in group before intubation,which were significantly lower than those after intubation([91±11] /min and [102±10] mmHg,all P0.05).The increases of HR and MAP were not significantly different between the two groups(P0.05).Conclusion Both fibreoptic bronchoscope technique and blind intubation device have high success rates for intubation and are easy to perform,with few complications.The blind intubation device can also be used for difficult airways that can not be resolved by fibreoptic bronchoscope.Furthermore,the blind intubation device has a lower cost;it can be used for orotracheal intubation in difficult airway patients receiving nasal plastic surgery,and it is worth popularizing.(Shanghai Med J,2010,33:702-704)