Modified double-lumen endobronchial tubes with EtCO2 oscillogram in anesthetic intubation of Patients with cervical spine fractures

Abstract

Objective To investigate the feasibility of solving incubation difficulty in patients with cervical spine fractures using blind tracheal incubation instrument transformed from double-lumen endobron-chial tubes with EtCO2 （end-tidal carbon dioxide） oscillogram monitoring. Methods Patients with cervical spine fractures suffered incubation difficulty were randomly divided into two groups： blind tracheal intubation group （group A, n = 25） and the group of modified double-lumen endobronchial tubes with EtCO2 monitoring （group B, n = 25）. Blind tracheal incubation was conducted in the two groups. The number of intubation, intubation duration （from the beginning to successful intubation proved by auscultation）, additional uses of anesthetics throughout the intubation period, blood pressure （BP）, heart rate （HR）, changes of oxygen saturation （SpO2）, and intubation complications were recorded, Results There was no significant difference between the two groups in assessment of intubation difficulty （P〉0.05）, the success rate of incubation for 1 to 2 times was significantly higher in group B than in group A （P〈0.05）, changes of BP and of HR were significantly smaller than in group A （P〈0.05）. No hypoxemia （SPO2 〈92%）, bucking, bronchial spasm, and other complications occurred. Conclusions Modified double-lumen ndobronchial tubes with EtCO2 oscillogram monitoring for patients with intubation difficulty, especially for those with cervical fractures, is a simple, safe, and effective procedure of endotracheal intubation, and is worth popularizing. Key words: Cervical spine fracture; Tracheal intubation; Modified double-lumen endobronchial tubes; EtCO2 oscillogram