Journal of Clinical Anesthesia 05/2010; 22(3):224-225. DOI:10.1016/j.jclinane.2010.02.001 · 1.19 Impact Factor
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ABSTRACT: To investigate the efficiency of a double curve nasotracheal tube on lightwand-guided nasotracheal intubation.
Prospective, randomized, controlled trial.
University medical center hospital.
60 ASA physical status I and II patients undergoing oromaxillofacial surgery.
Patients undergoing surgery with nasotracheal intubation and general anesthesia were randomly enrolled in the laryngoscopy group or the lightwand group. The same type of double curve nasotracheal tube was used in both groups. In the laryngoscopy group, intubation was assisted with a Macintosh No. 3 standard curved blade and Magill forceps. In the lightwand group, intubation was aided with a flexible lightwand device (without the inner stiff stylet). Intubation time was divided into two parts: Part one, from selected naris to oropharynx; Part two, from oropharynx into trachea. Part one, Part two, and total intubation time, hemodynamic responses to nasotracheal intubation, and adverse events or complications were recorded.
Total intubation times in the lightwand group and the laryngoscopy group were 22.8 +/- 8.0 sec vs 30.3 +/- 8.2 sec (P < 0.001), respectively. The lightwand group had comparable hemodynamic responses to those of the laryngoscopy group. Adverse events and complications were all self-limited, with similar occurrence in both groups.
For patients undergoing oromaxillofacial surgery, modified lightwand-guided nasotracheal intubation is feasible with a double curve nasotracheal tube and is an efficient alternative technique.
Journal of clinical anesthesia 06/2009; 21(4):258-63. DOI:10.1016/j.jclinane.2008.08.020 · 1.19 Impact Factor
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ABSTRACT: To investigate the changes in view of the laryngopharyngeal tissues on the fiberoptic bronchoscope (FOB) with different techniques of supporting the airway.
Prospective, observational, stratified study.
40 ASA physical status I, II, and III men undergoing elective oromaxillofacial surgery during general anesthesia with nasotracheal intubation.
Patients were allocated into the normal mouth-opening group (Group N) or the limited mouth-opening group (Group L) to determine the grade of view of the laryngopharyngeal tissues exposed on the FOB, with 5 different airway supporting techniques: original airway position (OA), triple airway (TA), jaw thrust with opened mouth (JTO), jaw thrust with teeth protrusion (JTP), and head tilt with chin lift (HT).
An adequate airway support was defined as having nearly full visibility of the entire glottic inlet. The investigator graded the vision of both anterior and posterior laryngopharyngeal tissues of each patient. All subjects experienced adequate airway support with the TA and HT airway supporting techniques. The TA airway supporting technique significantly moved the posterior laryngeal tissues more upward in Group N than Group L (P = 0.027). The JTP airway supporting technique provided adequate airway support for 14 of the 20 patients in Group N but only for two of the 20 Group L patients (P < .001).
Both the TA and HT techniques provided adequate airway support for patients with and without limited mouth opening.
Journal of Clinical Anesthesia 12/2008; 20(8):573-9. DOI:10.1016/j.jclinane.2008.01.013 · 1.19 Impact Factor