Clinical Evaluation Of Nasotracheal Intubation Using Shikani Optical Sytlet

Objective:To evaluate the feasibility of nasotracheal intubation in maxillo-facial surgery with Shikani optical stylet.Methods:One hundred ASA I or II patients aged 18-65yr udergoing elective maxillo-facial surgery under general anesthesia by nasotracheal intubation were included in this study. Fifty patients without predicted difficult intubation by pre-operative assessment were randomly divided into 2 groups (n=25each):group H (using Macintosh laryngoscope group) and group S1(using SOS group); Other Fifty patients with inadequate mouth opening (<3cm) but without difficult ventilation were randomly divided into 2 groups (n=25each):group S2(using SOS group) and group F(using fiberoptic bronchoscope, FOB).Group S1 and group H were under regular induction of anesthesia, and group S2 and group F anesthesia were induced with sevoflurane and propofol to reserve spontaneous breath. The parameters were compared between group S1 and group H, group S2 and group F, group S1 and S2 respectively inincluding exposure of glottis,intubation time,the number of tracheal cannulation, success rate of first time intubation, success rate of total intubation,,severity of epistaxis and postoperative nasal complications.Result: As compared with group H, exposure of glottis was significantly more completely, the intubation time and the number of tracheal cannulation was significantly less; the success rate of the first time inbutation and the success rate of total intubation were significantly higher, the epistaxis was significantly less in group S1 (P<0.05), there were no significant differences in nasal complications between group H and group S1 (P>0.05).As compared with group F, the intubation time was significantly less in group S2 (P<0.05); no significant difference was found in the exposure of glottis, the number of tracheal cannulation,the success rate of the first time intubation,the success rate of total intubation, severity of epistaxis and nasal complications between group S2 and group F(P>0.05).There was no significant difference in the above indices between group S1 and group S2 (P>0.05).Conclusion:Nasotracheal intubation using Shikani optical stylet is a handy and feasible strategy in maxillo-facial surgery. The method may be a suitable intubation method for those difficult intubation such as jaw opening problem.