The Choice Of The Way Of The Anticipated Difficult Intubation In Conscious Sedation And Surface Anaesthesia

Objective:To observe the effects of fiber bronchoscope versus video laryngoscopy in tracheal intubation for patients with anticipated difficult airway.Methods:Forty six patients with American Society of Anesthesiologists（ASA） Grade I-II anticipated difficult airway planning to receive elective surgery were randomized using random number table into the fiber bronchoscope group or video laryngoscopy group, each consisting of twenty three patients, to receive tracheal intubation under fiber bronchoscope or video laryngoscopy. Blood pressure and heart rate at 5min following stabilization in operation room（T₀）, 10 min following sedation（T₁）, immediately during tracheal intubation（T₂）, 1min following tracheal intubation（T₃）, 2min following tracheal intubation（T₄）, and 3min following tracheal intubation（T₅）,P_ETCO₂ following tracheal intubation, intubation success rate, as well as the incidences of sore throat and hoarseness during tracheal intubation and 24 h post-surgery were observed and recorded for both groups.Results:1. There was no significant difference in gender, age, weight and other general data between the two groups.2.The duration of tracheal intubation under fiber bronchoscope was significantly longer than under video laryngoscopy, with statistically significant difference（P<0.05）. Within 24 h post-surgery, the fiber bronchoscope group reported 2 cases of sore throat and 1 case of hoarseness, and the video laryngoscopy group reported 1 case of sore throat and 1 case of hoarseness.3.Blood pressure and heart rate decreased from T₀ to T₁ in both groups, with statistically significant differences from T₀ to T₁ in blood pressure and heart rate in bronchofibroscopy group and in DBP in video laryngoscopy group（P<0.05）. At T₂, T₃ and T₄, there had been increases from T₀ and T₁ in blood pressure in both groups; with the exception of the differences in heart rate from T₀ to T₄ in fiber bronchoscope group and from T₀ to T₂ in video laryngoscopy group, heart rate presented statistically significant differences at each point in both groups（P<0.05）.4.There were no statistically significant differences between the two groups in heart rate or blood pressure at any point（P>0.05）.Conclusion:Both fiber bronchoscope and video laryngoscopy could apply to patients with anticipated difficult airway who had undergone conscious sedation and surface anesthesia, resulting in comparable haemodynamics; however the duration of tracheal intubation under fiber bronchoscope was significantly longer than under video laryngoscopy.