Clinical Study Of Trachlight Guided Intubation

Objects:To evaluate the safety and effectiveness of Trachlight guided intubation in adult and pediatric patients.To compare the impact on intubation time and success rate of Trachlight with different bent angles and to observe the clinical effectiveness of Trachlight in predicted difficult intubation in pediatric and adult patients.Part one:Clinical observation of Trachlight guided intubation in adult patientsMethods:148 ASAⅠ-Ⅱadult patients undergoing elective plastic surgery with general anesthesia were enrolled in the study.Patients were randomly allocated to 45°group(groupA),60°group(groupB) and 90°group(groupC), according to the bent angle of theTrachlight.Search time,intubation time, success rate,hemodynamic changes during intubation and complications relative to intubation were recorded.Results:There were no statistical differences in success rate on the first attempt between groups.Final success rate between groups were not different.Search time(s) in group C(9.7±7.8) was longer than that in group A(5.2±3.5) and group B(6.0±3.5).Intubation time(s) in group C(15.9±8.0) was longer than that in group A(9.5±3.9) and group B(10.6±3.8). Hemodynamic changes during intubation were gentle and no severe complications were observed.Conclusion:Trachlight can be safely used for intubation in adult patients,with short intubation time,high success rate,and gentle hemodynamic changes during intubation.Search time and intubation time are shorter and it is easier to use when the tip of Trachlight bent to be 45°or 60°than 90°Part two:Clinical observation of Trachlight guided intubation in pediatric Datients Methods:200 ASAⅠ-Ⅱchildren undergoing elective plastic surgery with general anesthesia were divided into four groups:group A(n=50)(aged＜3, 60°),group B(n=50)(aged＜3,80°),groupC(n=50)(aged＞3,60°),group D(n=50)(aged＞3,80°),according to the years of age of the children and the bent angle of Trachlight.Intubation time,success rate,hemodynamic responses to tracheal intubation and complications were recorded.Results:Intubation time was not significantly different between children of the same age.With the same bent angle,intubation time was longer in group A and group B than that in group C and group D.There were no significant differences in success rate between all these four groups. But success rate of 80°bent angle groups was higher than that of 60°bent angle groups on the first attempt.Hemodynamic responses were gentle during intubation and no severe complications were recorded.Conclusion:Trachlight can be safely and effectively used in children and 80°bent angle is more suitable for use than 60°bent angle.Part three:Clinical observation of Trachlight guided intubation in patients with predicted difficult intubationMethods:50 ASAⅠ-Ⅱpatients with predicted difficult intubation undergoing elective plastic surgery with general anesthesia were enrolled in the study.There were 29 adult patients and 21 pediatric patients, respectively.All the patients were predicted to intubate with difficulty if they fell within the following criteria:mouth opening(interincisor distance) less than 3 cm,modified Mallampatti classificationⅢorⅣ, atlanto-occipital extension＜20°,body mass index(BMI)≥30,thyromental distance＜6cm.Patients were inbubated with abent angle of 80°and 90°in children and adults,respectively.Search time,intubation time and complications during intubation were recorded.Results:Of all these 50 patients with predicted intubaion,eighteen patients were pure limited mouth opening,fourteen patients were pure limited neck extension,five patients were limited mouth opening and neck extension,five patients were pure Mallampati classificationⅢorⅣ, seven patients were obesity and one patients was small chin.Search time (s) was(10.8±6.8),and intubation time(s) was(16.8±8.5).Success rate on the first attempt was 84%,and final success rate was 100%.No severe complications were recorded.Conclusion:Trachlight can be safely used in patients with predicted difficult inbubaion,with high success rate and short inbubation time.The bent annie shoud be 80°when used in difficult intubation.