Effects of lateral position on fiberoptic bronchoscope-guided orotracheal intubation under general anesthesia in patients with ankylosing spondylitis

Objective To evaluate the effects of lateral position on fiberoptic bronchoscope(FOB)-guided orotracheal intubation under general anesthesia in the patients with ankylosing spondylitis. Methods Forty-five patients with ankylosing spondylitis, aged 19-63 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were divided into 2 groups using the random number table: group supine position(group S, n=22)and group lateral position(group L, n=23). After induction of general anesthesia, orotracheal intubation was performed under the guidance of FOB.Intubation time, catheterization time, intubation condition and intubation-related complications were recorded.Mean arterial pressure(MAP)and heart rate(HR)were also recorded before anesthesia induction, immediately before intubation, immediately after onset of intubation, and at 2 and 4 min after intubation. Results The success rates of intubation were both 100% in the two groups.Compared with group S, the intubation time and catheterization time were significantly shortened, the success rates of intubation and catheterization at first attempt were increased, MAP and HR were decreased immediately after onset of intubation, and no significant change was found in intubation-related complications in group L. Conclusion Lateral position can raise the success rate of FOB-guided orotracheal intubation under general anesthesia with shorter operation time, it is helpful in stabilizing hemodynamics during intubation, and intubation-related complications are fewer in the patients with ankylosing spondylitis. Key words: Posture; Intubation, intratracheal; Bronchoscopy; Spondylitis, ankylosing