Efficacy of Disposcope endoscope-guided nasotracheal intubation in patients with difficult airway: a comparison with fiberoptic bronchoscope

Abstract

Objective To evaluate the efficacy of Disposcope endoscope(DE)-guided nasotracheal intubation in patients with difficult airway by comparing with fiberoptic bronchoscope(FOB). Methods One hundred and twenty American Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both sexes, with body mass index<25 kg/m2, aged 18-64 yr, with mouth opening<3 cm, of Mallampati classification Ⅲ or Ⅳ, undergoing maxillofacial surgery requiring nasotracheal intubation were divided into DE group(n=60)and FOB group(n=60)using a random number table.Nasotracheal intubation was performed under the guidance of DE or FOB after induction of anesthesia.Glottis exposure was evaluated using Cormack-Lehane grade.Epistaxis during intubation, successful intubation, time and degree of glottis exposure, intubation time and development of tachycardia and hypertension and requirement for assisted ventilation with face mask during intubation were recorded.The patients were followed up postoperatively, and the development of intubation-related complications was also recorded. Results Compared with group FOB, glottis exposure time and incubation time were significantly shortened(P 0.05). Hypertension and tachycardia were not found and no patients required assisted ventilation with face mask during intubation in the two groups. Conclusion DE-guided nasotracheal intubation provides similar efficacy to that of FOB with shorter time and is an optimal selection for the patients with difficult airway. Key words: Intubation, intratracheal; Nasal cavity; Laryngoscopy