The Clinical Study Of The Clarus Video System-Guided Tracheal Intubation

Part One:A clinical evaluation of Clarus Video System:a comparison of transillumination technique and video-monitoring techniqueObjectiveTo observe the clinical effect of Clarus Video System-guide tracheal intubation and compare effects of two endotracheal methods on Clarus Video System-guide intubation in adult patients with normal airway.Methods110 ASA class ??? adult patients undergoing selective surgery and requiring orotracheal intubation were allocated into transillumination group and video-monitoring group.After intravenous anesthesia induction,all patients were intubated with Clarus Video System by certain method.The intubation time,time of looking for glottis or trachea cartilage ring,number of attempts,success rate,hemodynamic changes and incidence of intubation-related intraoral injury were recorded.ResultsThe median intubation time using Clarus Video System in transillumination group and video-monitoring group is 28.67s VS 29.72s.The time of looking for glottis or trachea cartilage ring in transillumination group was significantly shorter than that in video-monitoring group(P<0.05).The overall success rate in transillumination group was also higher(100%VS 96.15%).Two failures in video-monitoring group became success after changing into using transillumination technique.The effects of intubation on hemodynamics were similar between two groups.ConclusionThe Clarus Video System is easy to manipulate with less hemodynamic changes and minimal injury to oral cavity.In normal airway,compared with video-monitoring technique,using transillumination technique can reduce the time of looking for glottis or trachea cartilage ring and improve the success rate as it can judge the aiming structure directly according to the light-spot in front of neck.But transillumination technique is a semi-blind technique,Physicians should make decisions in accordance with specific conditions.Part Two:Learning curve of the Clarus Video System:a comparison of transillumination technique and video-monitoring techniqueObjectiveTo evaluate the effect of two endotracheal intubation methods for Clarus Video System on the learning curve.MethodsTen novice practitioners qualified as an anesthetist less than or equal to 2 years and with no CVS experience were randomly assigned into transillumination group or video-monitoring group.Patients undergoing elective surgery and requiring orotracheal intubation were selected and were intubated with CVS using transillumination technique or video-monitoring technique.Intubations were performed by each novice and attempts,time of intubation,success rate and incidence of intubation-related intraoral injury were recorded;The learning curves for practitioners were established using the Cumulative Summation(CUSUM)method and the functional equations were calculated according to the polynomial fit technique.ResultsThere was no significantly difference among age,gender,education level in both groups.Video-monitoring group required approximately 17 cases of attempts to complete the learning curve while 11 cases for transillumination group.The learning curve of transillumination group was better than video-monitoring group(P<0.05).There were no significantly difference between two groups in the mean interval before the curve peak and the time of intubation after the curve peak(P>0.05).Conclusion11?17 intubations are sufficient to learn Clarus Video System utilization properly without causing any severe orodental trauma.It is a useful skill with short learning curve and easy to handle.In normal airway,the learning curve of Clarus Video System using transillumination method is better than the video-monitoring method,and it is worth of being generalized.