Application Of Shikani Optical Stylet In Tracheal Intubation Of Patients With Abnormal Incisors

Objective :To compare the application effect of shikani optical stylet(SOS)and direct laryngoscope in tracheal intubation under general anesthesia in patients with abnormal incisors and non-difficult airway.To compare the application effect of Tuoren video laryngoscope and SOS on general anesthesia tracheal intubation in patients with abnormal incisors and predicted difficult intubation.To explore the application value of SOS in tracheal intubation of patients with abnormal incisors.Methods :This experiment is divided into two parts.The first part is the comparative experiment of the application of direct laryngoscope and SOS in non-difficult airway with abnormal incisors.The second part is the comparative test of the application of Tuoren video laryngoscope and SOS in patients with abnormal incisors to predict difficult intubation.The first partFrom January 2021 to April 2022,100 cases of elective non-maxillofacial and cervical tracheal intubation general anesthesia were selected.American Society of Anesthesioiogists(ASA)grade I or II,Mallampati grade I-II,aged 16-55 years,height 145-175 cm,abnormal incisors(loose incisors,periodontal disease,incisor protrusion,dental caries,etc.),according to the random number method,were randomly divided into 2 groups.Direct laryngoscope group(group D,n = 50)and SOS group(group S,n = 50).After routine induction,direct laryngoscope and SOS were used for tracheal intubation according to the grouping.Cormach-Lehane grade(C-L grade),intubation time,intubation times,one-time intubation success rate and total intubation success rate,intubation-related complications,heart rate(HR)and mean arterial pressure(MAP)before anesthesia induction(T0),after anesthesia induction(T1),intubation(T2),1 min after intubation(T3),3 min after intubation(T4),5 min after intubation(T5)were recorded.Results : The two groups of patients were compared with different laryngoscopes for glottis exposure.The C-L grading of glottis in group S was better than that in group D(P < 0.05).The intubation time in group S was significantly shorter than that in group D(P < 0.05).There was no significant difference in the success rate of one-time intubation and total intubation between the two groups(P > 0.05).There was no significant difference in MAP and HR between the two groups at each time point(P > 0.05).The incidence of gingival bleeding and sore throat after tracheal intubation in group S was lower than that in group D(P < 0.05).The second partFrom January 2021 to April 2022,60 patients undergoing elective non-maxillofacial and cervical tracheal intubation general anesthesia were selected.American Society of Anesthesiologists(ASA)grade I or II,Mallampati grade III-IV,aged 16-55 years,height 145-175 cm,there are problems of incisors(loose incisors,periodontitis of incisors,protrusion of incisors,caries of incisors,etc.),according to the random number method,they were randomly divided into 2 groups,Tuoren video laryngoscope group(group A,n = 30)and SOS group(group B,n = 30).After routine induction,the Tuoren video laryngoscope and SOS were used for tracheal intubation according to the grouping.The C-L grade,tracheal intubation time,intubation times,success rate of one-time intubation and total intubation success rate,tracheal intubation-related complications,heart rate(HR)and mean arterial pressure(MAP)before anesthesia induction(T0),after anesthesia induction(T1),tracheal intubation(T2),1 min after tracheal intubation(T3),3 min after tracheal intubation(T4),5 min after tracheal intubation(T5)were recorded.Results : There was no significant difference in glottic C-L grade between the two groups(P > 0.05).The intubation time of group B was significantly shorter than that of group A(P < 0.05).The success rate of one-time intubation in group B(93.3 %)was significantly better than that in group A(73.3 %)(P < 0.05),but there was no significant difference in the success rate of total intubation between the two groups(P > 0.05).There was no significant difference in MAP and HR between the two groups at each time point(P > 0.05).The incidence of gingival bleeding and sore throat after tracheal intubation in group B was lower than that in group A(P <0.05).Conclusion :Compared with traditional direct laryngoscope,SOS can better expose glottis,shorten intubation time and reduce gingival bleeding,sore throat and other related complications after intubation in patients with abnormal teeth and non-difficult airway.SOS compared with Tuoren video laryngoscope in patients with abnormal teeth and possible difficult airway to improve the success rate of one intubation,intubation time,reduce gingival bleeding,sore throat and other intubation-related complications.The clinical application value of SOS in tracheal intubation of patients with abnormal incisors is significant.