Efficacy Of The Disposcope Endoscope, For Endotracheal Intubation In Patients With Cervical Spine Immobilisation By Semirigid Neck Collar: Comparison With The Fiberoptic Bronchoscope

Objective：To compare the efficacy to endotracheal intubation withDisposcope endoscope and Fiberoptic bronchoscope in patients with cervical spineimmobilisation by semirigid neck collar.Methods：Sixty ASA physical status Ⅰ-Ⅱ adult patients requiring generalanesthesia from September2013to January2014in the Fengxian Branch of theShanghai Six People’s Affiliated Hospital of Shanghai Jiao Tong University，there isno limit on the gender，aged18～60，BMI18to26kg/m2，according to the methodused for intubation，were randomly divided into two groups，disposcope andfiberoptic bronchscope were intubated in Disposcope group（D group，n=30）and FOBgroup(F group，n=30）， respectively. Wearing a neck collar before anesthesiainduction and after general anesthesia induction， blood pressure (BP) and heart rate(HR) were recorded before induction， before intubation and after intubation. Theglottis exposure time, the time of glottis exposure to successful intubation，the numberof intubation attempts，intubation successful cases at a time，the cases of successfulintubation time no than one minute and the bleeding of intubation and complications(hoarseness and pharyngalgia) after24hours of surgery were also recorded.Results：1.Systolic blood pressure(SBP)，diastolic blood pressure(DBP) andHR before intubation were significantly lower than those before indution in allpatients (p<0.05)，SBP and DBP after intubation were significantly lower than thosebefore indution in Disposcope group(p<0.05)，SBP、DBP and HR in Disposcopegroup were significantly lower than those in FOB group after inbutation in allpatients(p<0.05). 2.The time of glottis exposure of D group was （17.8±12.5）S，the time ofglottis exposure of F group was （17.8±12.5）S，the time of glottis exposure were notsignificantly different between groups (p>0.05).The time of glottis exposure tosuccessful intubation of D group was （2.7±0.7）S，The time of glottis exposure tosuccessful intubation of F group was （13.4±7.1）S, the time of glottis exposure tosuccessful intubation of D group was shorter than F group (p<0.05).3.The rate of intubation successful cases at a time of D group was90%，therate of intubation successful cases at a time of F group was97%，the rate of totalintubation successful cases of D group was97%，the rate of total intubation successfulcases of F group was100%（P>0.05）. The rate of cases of successful intubation timeno than one minute of D group was93%， the rate of cases of successful intubationtime no than one minute of F group was83%（P>0.05），the D group of the cases ofsuccessful intubation time no than one minute were more than F group，but onepatient in D group failed in first and the second intubation，and this patient succeededin intubation by fiberoptic bronchoscope.4. There was one patient who has pharyngalgia each group (after24hoursof surgery)，there were not bleeding of intubation and hoarseness(after24hours ofsurgery)，the incidences of intubation complications were not significantly differentbetween D group and F group（P>0.05）.Conclusion: Disposcope endoscope is safe and effective in patients withcervical spine immobilization. It can significantly shorten time of intubation anddecrease stress reaction of intubation， but disposcope endoscope cannot completelyreplace fiberoptic bronchoscope used in patients with difficult airway and cervicalspine immobilization.