Efficacy of fiberopfic bronchoscope-guidcd tracheal intubation with laryngeal mask airway iogel in patients undergoing cervical spine surgery

Abstract

Objective To evaluate the efficacy of fiberoptic bronchoscope （FOB）-guided tracheal intubation with laryngeal mask airway i-gel （LMA i-gel） in patients undergoing cervical spine surgery. Methods Forty ASA Ⅰ or Ⅱ patients, aged 36-62 yr, weighing 57-78 kg, scheduled for cervical spine surgery under general anesthesia, were randomly divided into 2 groups （n = 20 each）： FOB-guided tracheal intubation with oropharynx ventilation tube group （group O） and FOB-guided tracheal intubation with LMA i-gel （group I）. Anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 2-3 μg/kg and rocuronium 0.9 mg/kg. The intubation time, fiberoptic bronchoscope score, the number of successful intubation, hypertension, tachycardia and hypoxemia were recorded. All the patients were followed up postoperatively for adverse effects like sore throat or hoarseness, etc. Results The rate of successful LMA i-gel placement at first attempt was 100%, placement time was （10 ＋ 3） s, and the rate of successful intubation in the two groups was 100%. The intubation time was significantly shorter, the rate of successful intubation at first attempt and fiberoptic bronchoscope score were significantly higher in group I than in group O （P 〈 0.05）. Hypertension, tachycardia and hypoxemia were not found in the two groups. There was no significant difference in the incidence of adverse effects between the two groups （P 〉0.05）. Conclusion FOB-guided tracheal intubation with LMA i-gel can provide adequate ventilation during operation, improve the success rate of FOB-guided intubation and shorten the intubation time in patients undergoing cervical spine surgery. Key words: Laryngeal masks; Intubatiun,intratracheal; Bronchoscopy