Clinical Application And Comparison Of Median Forward Approach And Retrograde Sideslip Method In Lightwand Tracheal Intubation

Background:Recent years,the traditional median forward approach has been used in the lightwand guided endotracheal intubation.However,because the beginner has no rich experience,it is easy to cause additional damage to the patient during the intubation operation,so the retrograde sideslip method is proposed.Objective:In this study,we compared the time,success rate of intubation and the incidence of postoperative complications of lightwand intubation with the method of retrograde sideslip and the method of median forward intubation for beginners to explore a more appropriate method of lightwand intubation,so as to provide a reference for clinical practice.Methods:Approved by the ethics committee of the first hospital of Jilin University,200 patients with general anesthesia intubation were selected and randomly divided into two groups,median forward approach(group A,n = 100)and retrograde sideslip approach(group B,n= 100).Twenty residents who had just learned the lightwand tracheal intubation were randomly used 5 times eachmethod to carry out the intubation operation for the patients.The success rate of intubation,intubation time and the incidence of throat pain,cough and hoarseness were respectively compared between the two groups.Results were statistically analyzed using IBM SPSS25.0 software.Results:(1)There was no significant difference between the two groups in age,gender,height,weight,BMI,ASA classification,thyromental distance,mouth opening degree,Mallampati classification(P > 0.05).(2)The success rate of intubation between group B and group A was 87% vs 71%,the difference was16%,95% CI was 3.8% ~ 27.6%,the difference was statistically significant(P< 0.05).(3)The intubation time ratio between group B and group A was 33 [27;53] s vs 57 [40;120] s,the difference was statistically significant(P < 0.05).(4)The incidence of throat pain,cough and hoarseness in group A was significantly higher than that in group B at 1h and 6h after surgery(P < 0.05),and the incidence of throat pain in group A was significantly higher than that in group B at 24 h after surgery(P<0.05).Conclusion:Compared with the traditional median forward approach,the retrograde sideslip approach is a superior method for lightwand tracheal intubation,which has a higher success rate,a shorter intubation time and a smaller throat injury,It can be used in clinical practice.