| Objective:To evaluate the application value of Shikani in Double-lumen endotracheal intubation by comparing to direct laryngoscopy and video laryngoscopy upon success rates, injury and hemodynamic effects.Methods:1. Sample selection:120patients in ASA physical statusⅠ-Ⅱaged18-50years and scheduled for double-lumen endotracheal catheter intubation under general anesthesia were selected from the thoracic surgery department of the Second Xiangya Hospital of Central South University. Patients with severe cardiovascular disease, Systemic metabolic disease, Oropharyngeal disease, Neck disease, or other reasons that may be the cause of unable to exposing trachea structures were excluded from this study. The patients were randomly divided into3groups, the direct laryngoscopy group (Group A, n=40), the video laryngoscopy (Group B, n=40) and Shikani (Group c, n=40).2. Protocol:Patients were kept away from smoking for two weeks before operation. Use midazolam0.05mg/kg, fentanyl4ug/kg, propofol2mg/kg, cis-Atracurium0.2mg/kg through intravenous injection and face mask for oxygen at the same time during induction of anesthesia. Double-lumen endotracheal tube intubations were performed after intravenous injection of cis-atracurium for3minutes.3. Data collection:Time points were set as follows:To-prior to anesthesia induction, Ti-prior to endotracheal intubation, T2-the time when direct laryngoscopy and video laryngoscopy lift epiglottis, or Shikani reach the glottis, T3-endotracheal tube were put in place, T4-2min after intubation, T5-5min after intubation. Record the total time, the number of attempts, failure cases, injury cases as well as immediate hemodynamic parameters such as HR, MAP, SBP, DBP of each group at every time point during intubation.Results:1. The total time used for intubation in group C was statistically significantly shorter than that of group A, P<0.05, while there was no significant difference between group C and group B;2. The success rates of intubation show that group C and group B stayed in comparable level upon overall success rate, which were significantly higher than group A. One-time intubation success rate of group C was significantly higher than group A, but lower when compared to group B, both with statistical significance (P<0.05);3. The injury the situation of intubation show that injury rate of group C (5%) is statistically significantly lower than that of group A (25%) and B group (15%) respectively.4. Comparison of hemodynamic effects during Intubation show that HR, SBP, DBP were significantly lower in group C than that of group A, and MAP, DBP of group C were significantly lower than that of group B (P<0.05)at the time point of T2(P<0.05), besides, HR, MAP, SBP, DBP of group C were significantly lower both A group and B group (P<0.05) at the time point of T3. The hemodynamic parameters of group C take the minimal fluctuation during the whole course.Conclusion:1.In the Double-lumen endotracheal intubation, Shikani takes shorter time, higher success rate, less oropharyngeal injury and hemodynamic effects comparing to ordinary direct laryngoscopy. When compared to video laryngoscope, the Intubation time and overall success rate are nearly the same, but oropharyngeal injury and hemodynamic effects of Shikani are less than video laryngoscope.2.Therefore, Shikani laryngoscope has an advantage on mitigating effects on hemodynamics with oropharyngeal injury reduction comparing to both direct laryngoscope and video laryngoscope, which make it an effective tool for the implementation of the double-lumen endotracheal tube intubation. |
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