Comparison between stylet and bougie with the C-MAC D-blade in cervical simulated immobility. A prospective randomized controlled trial

Introduction The C-MAC D-blade was designed for difficult airway intubation scenarios. To facilítate easier and faster endotracheal intubation in the laryngoscopy paradox, an introducer is preferred. Hence, we decided to conduct a study to compare the 60° angled C-MAC stylet and the gum elastic bougie as aids to intubation while using the C-MAC D-blade laryngoscope in a simulated difficult airway setting. Objective To compare the ease of oral intubation with the use of the C-MAC stylet (60° angled stylet) versus intubation performed over a bougie inserted using the C-MAC D-blade guidance in patients with simulated restricted cervical mobility. Method Prospective, randomized controlled single-center study. Intubation using the C-MAC D-blade laryngoscope was performed in 48 surgical patients randomly assigned to 2 groups of 24 each: Stylet group, Group S (using 60° angled stylet) and Bougie group, Group B (using bougie) after providing manual in-line stabilization to restrict cervical mobility. The Mann-Whitney U test and the Chi square test were used as applicable. Results The use of stylet resulted in easier (Group S 75% vs. Group B 16.7%) and faster (Group S 26.83 ± 8.61s vs. Group B 47.18 ± 16.46s) intubation with fewer attempts compared to group B. Both groups experienced a similar hemodynamic stress response to intubation. Conclusions The 60° angled C-MAC Stylet is a more effective and time-saving intubation aid with C-MAC D-blade compared to bougie.

Introducción: El videolaringoscopio C-MAC D-blade se diseñó para los casos de intubación de la vía aérea difícil. Para facilitar una intubación más rápida y sencilla en la paradoja de la laringoscopía se prefiere un introductor. Por tanto, decidimos realizar un estudio para comparar el estilete de 60° C-MAC y el bougie elástico de goma como ayudas para la intubación utilizando el laringoscopio C-MAC D-blade en una situación simulada de vía aérea difícil. Objetivo: Comparar la facilidad de intubación oral mediante el uso del estilete del C-MAC (estilete angulado de 60°) con la intubación realizada sobre un bougie insertado con la guía del C-MAC D0-blade en pacientes con restricción simulada de la movilidad cervical. Métodos: Estudio prospectivo, aleatorizado y controlado realizado en un solo centro. Se realizó intubación utilizando el laringoscopio C-MAC D-blade D en 48 pacientes quirúrgicos asignados aleatoriamente a 2 grupos de 24 cada uno: grupo de estilete, grupo S (con el estilete angulado de 60°) y el grupo de bougie o grupo B (con bougie) después de establecer una estabilización manual del eje para restringir la movilidad cervical. Se aplicaron las pruebas U de Mann-Whitney U y de Chi cuadrado según correspondiera. Resultados: Con el estilete fue más fácil (Grupo S 75% vs. Grupo B 16.7%) y más rápida (Grupo S 26.83 ± 8.61s vs. Grupo B 47.18 ± 16.46s) la intubación, requiriéndose un menor número de intentos en comparación con el Grupo B. Los dos grupos experimentaron un estrés hemodinámico similar en respuesta a la intubación. Conclusiones: El estilete angulado de 60° C-MAC es una ayuda más efectiva y ahorra más tiempo con el C-MAC D-blade en comparación con el bougie.

Origen y evolución de una vía aérea permeable / The origin and evolution of a permeable airway

Resumen: A través de los siglos hemos descubierto la importancia de mantener permeable y segura la vía aérea. Desde Hipócrates en la antigua Grecia, hasta el siglo XX en oriente y occidente, se ha continuado con el desarrollo de herramientas que faciliten esta cotidiana tarea por lo que, con esta revisión sistemática, se establecieron como objetivos exponer el origen y los antecedentes del tubo endotraqueal, cánula orofaríngea y laringoscopio, así como discutir su utilidad en la práctica anestésica-quirúrgica, a través del tiempo hasta hoy en día.

Abstract: Over the centuries, we have discovered the importance of preserving a safe permeable airway. From Hippocrates in ancient Greece to the 20th century in the East and West, the development of multiple tools that enable this task continues through time, which is why with this systematic review we aim to uncover the origin and historical background of the endotracheal tube, the oropharyngeal cannula and the laryngoscope, discussing their effectiveness in the anesthetic-surgical practice over years to the present day.

Anesthetic induction and endotracheal intubation in the sitting position due to the fixed forearm caught by a meat grinder

Abstract A male patient was scheduled for urgent amputation of his right forearm. His right forearm was stuck inside the insertion slot of a meat grinder, resulting in severe pain to his injured arm. His upper body could not move to sit in a semi-upright position. An endotracheal tube was successfully placed after rapid sequence intubation using a video laryngoscope from behind the patient on the first attempt. This case report is the first documentation of successful anesthetic induction with subsequent endotracheal intubation using a video laryngoscope from behind an injured patient whose upper body was upright with limited positioning.

Supraglottic device for circumventing bag-mask ventilation in giant lip hemangioma

Congenital hemangiomas are benign tumors of endothelium most often occurring as a solitary lesion with a predilection for the head-and-neck. This report presents a case of a giant friable hemangioma of the lower lip in a 1-month-old male child posted for excision of the lesion. Airway management was challenging as the size, site, and history of repeated local site bleeding made mask ventilation impossible. Bypassing mask ventilation, a supraglottic device (SGD) was directly inserted and adequate lung ventilation was ensured followed by C-MAC� video laryngoscope-guided intubation. Challenging extubation was also overcome by the use of a SGD. This case demonstrates how an airway with impossible bag and mask ventilation can be managed by securing the airway with SGD before intubation.

Laringoscopio híbrido: Una opción de costo razonable para el abordaje de la vía aérea difícil. Reporte de un caso / Hybrid laryngoscope: A reasonable option cost for approaching the airway difficulty. A case report

The laryngoscope is a primary tool that every medical professional who performs in airway care should know how to use. Although it's an irreplaceable tool, in the last decade have been considered transformations and modifications in them that have allowed the medical professional, especially the anesthesiologist to perform successfully for critical management especially in the context of unanticipated difficult airway, because most of the time the only available resource at hand is the laryngoscope and a malleable stylet that guides the orotracheal. The new technological age of visual instruments such as video cameras and photographs many of these with small sizes, has been used in the manufacture of video laryngoscopes that today are used, which have managed to approach the aerea in a minimally traumatic way and also safeguard lives. Our hydrid video laryngoscope is a handcrafted tool made of high-quality elements, strength, durability and low cost.

El laringoscopio es una herramienta primordial que todo profesional médico que se desempeña en la atención de la vía aérea debería saber utilizar. Pese a ser un dispositivo insustituible, en la última década se han considerado transformaciones y modificaciones en los mismos que le han permitido al profesional de la medicina, fundamentalmente al anestesiólogo, desempeñarse exitosamente durante el manejo crítico especialmente en el contexto de vía aérea difícil no anticipada, en el que la mayoría de las veces el único recurso disponible a la mano es el laringoscopio y un estilete maleable que sirve de guía para dirigir la sonda orotraqueal. La nueva era tecnológica de los instrumentos visuales como cámaras de video y fotografía, (muchos de estos con tamaños reducidos) han sido empleados en la fabricación de videolaringoscopios que hoy en día se utilizan y que han logrado abordar la vía aérea de manera mínimamente traumática, así mismo, salvaguardar vidas. Nuestro videolaringoscopio híbrido es una herramienta artesanal fabricada con elementos de alta calidad, resistencia, durabilidad y bajo costo.

Effect of combined teaching of optical laryngoscope and general laryngoscope on anesthesia undergraduate practice / 中华医学教育探索杂志

Objective:To evaluate the effect of combined teaching of optical laryngoscope and general laryngoscope on anesthesia undergraduate practice.Methods:A total of 40 anesthesia undergraduate students were randomly divided into group A (using the optical laryngocope only in the first month and the general laryngoscope only in the second month, n=20), and group B (using the general laryngocope only in the first month and the optical laryngoscope only in the second month, n=20). The teaching effect was evaluated through the first month and the second month of tracheal intubation assessment and questionnaire survey results. SPSS 23.0 was used for t test and chi-square test. Results:In the first month, the success rate was 90% in group A and 60% in group B, which showed that the success rate of group B was lower, with significant differences ( P < 0.05). The time for tracheal intubation in group A was (61.8±5.0) s, and that in the group B was (83.0±4.9) s, showing that the time of group B was longer, with significant differences ( P < 0.05). The complications in group A was 5%, and that in group B was 14%, showing that the group B had more cases of implications, with significant differences ( P < 0.05). In the second month, there was no significant difference in the one-time success rate, the time for tracheal intubation, and complications between the two groups ( P > 0.05). There was no significant difference in one-time success rate and complications between groups. Both groups showed that the time for general laryngoscope intubation was longer, with significant differences ( P < 0.05). All of the students believed that applying optical laryngoscope teaching was beneficial and could enhance the interest of learning, and the combination of the two methods was better. Conclusion:Using the optical laryngoscope first and then the general laryngoscope teaching is more beneficial for students to master the two methods of tracheal intubation, improve the success rate, reduce complications, and cultivates their self-confidence.

Comparison of the emergency effect between visual laryngoscopee and traditional laryngoscope / 中国医师进修杂志

Objective:To investigate the effectiveness and advantage of visual laryngoscope in the treatment of patients with sudden cardiac arrest who need spontaneous respiration tracheal intubation.Methods:Totally 60 patients who suffered from cardiac arrest and needed spontaneous respiration tracheal intubation were enrolled from June 2020 to February 2021 in the Affilicated Hospital of Chifeng University. Theywere randomlydivided into two groups-traditional laryngoscope (TL) group and visual laryngoscope (VL) group, with30 patients in each group. Then the success rate of glottis exposure, the operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Subgroup assessment between the junior emergency resident doctor (A group) and the senior emergency resident doctor (B group) was conducted.Results:According to Cormack Lehan grades, the success rate of glottis exposure in VL group was higher than that in TL group ( P>0.05), and the success rate of Grade I in VL group was significant higer than that in TL group: 56.70%(17/30) vs. 30.00%(9/30), P<0.05. The trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in TL group (1.30 vs 1.67, P = 0.049) and (56.37 s vs 67.12 s, P<0.05). In the subgroup, the one-time success rate of tracheal intubation in A-TL group was significantly lower than that in B-TL group (4/15 vs. 11/15, P<0.05), while the one-time success rate of tracheal intubation in A-VL group was 60.00%, which is lower than that in B-VL group ( P>0.05). The operative time consumed for successful intubation in A-TL group was significantly longer than that in B-TL group: 78.00 s vs. 55.57 s, P<0.05, while the operative time in A-VL group was a little longer than that in B-VL group ( P>0.05). Conclusions:Visual laryngoscope used in spontaneous respiration tracheal intubation can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation.

Anestesia en paciente pediátrico con Síndrome de Treacher Collins / Anesthesia in pediatric patient with Treacher Collins Syndrome

El Síndrome de Treacher Collins (STC) constituye un reto para el anestesiólogo por malformaciones craneofaciales que complican el manejo de su vía aérea e intubación. Presentamos el caso de una paciente (8 años) con diagnóstico de STC que debía someterse a una cirugía de colocación de implante de conducción ósea bajo anestesia general. Presentaba un antecedente de intubación difícil, marcada micrognatia y distancia tiromentoniana de 2 cm. Se planteó un esquema de intubación en dos etapas secuenciales. En la primera etapa se realizó una evaluación de la vía aérea (visualización de la glotis) bajo sedación con dexmedetomidina, remifentanilo y propofol. Al visualizar la glotis se pasó a la segunda etapa para realizar la intubación posterior a la inducción anestésica. El manejo exitoso se fundamentó en una sedación adecuada y la utilización de un videolaringoscopio con pala curva para la evaluación previa de la vía aérea y posterior intubación sin complicaciones.

Treacher Collins Syndrome (TCS) constitutes a challenge for the anesthesiologist due to craniofacial malformations that make management of the airway and intubation difficult. We present a case of a patient (8-year-old) diagnosed with TCS who had to undergo surgery for the placement of a bone conduction implant under general anesthesia. She had a history of difficult intubation, marked micrognathia and a thyromental distance of 2 cm. An intubation scheme in two sequential stages was proposed. In the first stage, an evaluation of the airway (visualization of the glottis) was carried out under sedation with dexmedetomidine, remifentanil and propofol. When the glottis was visualized, we proceeded to the second stage to carry out intubation after anesthetic induction. The successful management of this case was based on adequate sedation and the use of a video laryngoscope with a curved blade for prior evaluation of the airway and subsequent intubation without complications.

Anestesia en paciente pediátrico con Síndrome de Treacher Collins / Anesthesia in a pediatric patient withTreacher Collins Syndrome / Anestesia em paciente pediátrico com Síndrome de Treacher Collins

El Síndrome de Treacher Collins (STC) constituye un reto para el anestesiólogo por malformaciones craneofaciales que complican el manejo de su vía aérea e intubación. Presentamos el caso de una paciente (8 años) con diagnóstico de STC que debía someterse a una cirugía de colocación de implante de conducción ósea bajo anestesia general. Presentaba un antecedente de intubación difícil, marcada micrognatia y distancia tiromentoniana de 2 cm. Se planteó un esquema de intubación en dos etapas secuenciales. En la primera etapa se realizó una evaluación de la vía aérea (visualización de la glotis) bajo sedación con dexmedetomidina, remifentanilo y propofol. Al visualizar la glotis se pasó a la segunda etapa para realizar la intubación posterior a la inducción anestésica.El manejo exitoso se fundamentó en una sedación adecuada y la utilización de un videolaringoscopio con pala curva para la evaluación previa de la vía aérea y posterior intubación sin complicaciones

Treacher Collins Syndrome (TCS) constitutes a challenge for the anesthesiologist due to craniofacial malformations that make management of the airway and intubation difficult. We present a case of a patient (8-year-old) diagnosed with TCS who had to undergo surgery for the placement of a bone conduction implant under general anesthesia. She had a history of difficult intubation, marked micrognathia and a thyromental distance of 2 cm. An intubation scheme in two sequential stages was proposed. In the first stage, an evaluation of the airway (visualization of the glottis) was carried out under sedation with dexmedetomidine, remifentanil and propofol. When the glottis was visualized, we proceeded to the second stage to carry out intubation after anesthetic induction.The successful management of this case was based on adequate sedation and the use of a video laryngoscope with a curved blade for prior evaluation of the airway and subsequent intubation without complications

A síndrome de Treacher Collins (STC) constitui um desafio para o anestesiologista devido às malformações craniofaciais que dificultam o manejo da via aérea e a intubação. Apresentamos o caso de uma paciente (8 anos) com diagnóstico de STC que foi submetida a uma cirurgia para colocação de implante de condução óssea sob anestesia geral. Ela tinha história de intubação difícil, micrognatia acentuada e distância tiromentoniana de 2 cm. Foi proposto um esquema de intubação em duas etapas sequenciais. Na primeira etapa, foi realizada avaliação das vias aéreas (visualização da glote) sob sedação com dexmedetomidina, remifentanil e propofol. Quando a glote foi visualizada, a segunda etapa foi realizada para realização da intubação após a indução anestésica. O manejo bem-sucedido baseou-se na sedação adequada e no uso de videolaringoscópio com lâmina curva para avaliação prévia da via aérea e posterior intubação sem complicações

Comparison of Intubation Characteristics of McCoy Laryngoscope and LMA CTrach with Cervical Collar in Situ- A Simulation Study.

Cervical spine motion restriction is an integral component of protocol for management of trauma victims. The use of rigid cervical collar for the same, presents a hurdle in airway management in patients where intubation is mandated for successful resuscitation. Hence, techniques alternative to conventional laryngoscopy need to be explored through simulation studies, to ease the process of intubation and benefit the actual trauma victims. We wanted to assess the performance of McCoy laryngoscope and LMA CTrach assembly and compare the intubation characteristics in patients with cervical collar.METHODS80 patients of ASA status I or II, scheduled for elective surgery requiring general anaesthesia and endotracheal intubation were randomly allocated to two groups- A and B. Patients in Group A were intubated using McCoy laryngoscope and Group B using LMA CTrach, with cervical collar in situ. Airway assessment included measuring thyromental distance, observing MPC grade and measuring inter-incisor distance, before and after application of semirigid cervical collar. Glottic view was noted using modified Cormack-Lehane grading. Device insertion time, total intubation time, number of attempts, haemodynamic factors and airway complications during the procedure were noted.RESULTSThere was decrease in inter-incisor distance and worsening of MPC grade in both groups post application of cervical collar. The time taken for device insertion in Group A was 16.95 + 3 sec, and in Group B was 33 + 4 sec (P= 0.0001). The total intubation time in Group A was 40.4 + 6 sec and in Group B was 57.4 + 4.37 sec (P= 0.0001). CL grade I was more common in Group B (31) than Group A (17) (P= 0.003). The number of attempts required, mean haemodynamic parameters and airway complication were comparable between the two groups.CONCLUSIONSThe McCoy laryngoscope requires less time to obtain glottic view and subsequent intubation, but LMA CTrach provides better glottic exposure. Thus, LMA CTrach has better performance characteristics in patients with cervical collar in situ.

King Vision Videolaryngoscopy Versus Direct Laryngoscopy in Patients Requiring Endotracheal Intubation for General Anaesthesia: A Comparative Study

With new advances in technology, intubation using video laryngoscopy has been gaining popularity, particularlyin patients with difficult airways or as rescue devices in failed intubation attempts. This study was done tocompare the effectiveness of King Vision video laryngoscope (KVL) and Macintosh laryngoscope whenperforming tracheal intubation under general anesthesia Eighty patients requiring endotracheal intubationduring general anaesthesia were randomly assigned into two groups to undergo tracheal intubation usingeither a King Vision video laryngoscope (n=40) or Macintosh laryngoscope (n=40). The primary outcomeswere the time of intubation and Cormack-Lehane grading and secondary outcomes were number of attemptsand optimisation manoeuvres required and complications related to laryngoscopy and intubation. King Visionvideo laryngoscope was found to be significantly better than the Macintosh laryngoscope in terms of Cormackand Lehane grading, requirement of optimisation manoeuvres and need of second attempt for intubationexcept time of intubation which was comparable between the two groups.

Comparative Evaluation of Macintosh, McCoy and Truview Laryngoscope in Simulated Difficult Laryngoscopy Using Rigid Neck Collar in Overweight Patients : A Randomized, Controlled Clinical Trial

Background: To compare the safety and efficacy of Macintosh, McCoy and Truview laryngoscope in simulated difficult laryngoscopy using rigid neck collar in overweight patients. Methods: It was a Prospective, randomized, controlled clinical trial conducted in a tertiary care teaching hospital. Overweight patients (BMI= 25-29.9) with American Society of Anesthesiologists physical status I and II, age 18 to 60 years and scheduled recruited for elective surgery requiring general anesthesia with oral endotracheal intubation were included. The patients were divided into three groups comprising of 40 patients each in which Macintosh, McCoy and Truview laryngoscopes were used respectively. Difficult laryngoscopy was simulated using rigid neck collar. The primary outcome measure was modified Intubation Difficulty Score (IDS ). The secondary outcome measures were number of attempts, ease of intubation, overall success rate, time of intubation, Percentage of Glottic Opening score, hemodynamic parameters and complications. Results: The mean Intubation Difficulty Score was significantly lower with Truview Laryngoscope (1.68) as compared to Macintosh (4.21)and MacCoy (3.03) laryngoscopes. The median Percentage of Glottic Opening score was also significantly improved in the Truview group(78.21) compared to the other groups. Number of successful first intubation attempt was significantly higher in the Truview group(63.16%) compared to the other groups. The overall success rate was similar among groups. However, the time of intubation was significantly higher for Truview (41.21±2 sec) compared to Macintosh and McCoy laryngoscopes. Conclusion: The Truview laryngoscope allowed better glottic visualization, greater ease of intubation, fewer intubation attempts, but a longer intubation time compared to Macintosh and MacCoy laryngoscopes.

Comparison of Glottic View and Haemodynamic Stress Response Associated with Laryngoscopy using the Macintosh, McCoy and Miller Blades in Adult Patients

Introduction: Laryngoscopy induces haemodynamic responsewhich has implications for patients with cardiovascularillnesses. We devised this study to compare the laryngoscopicview of the glottis obtained with the Macintosh, McCoy andMiller blades, and corresponding haemodynamic changes.Material and Methods: 105 ASA grade I and II patientsrandomly divided into three groups were intubated usingMacintosh, McCoy and Miller blade respectively. Cormackand Lehane grade of glottic view obtained, heart rate, systolicand diastolic blood pressure at baseline, immediately beforeinduction, following induction, and at 1, 3 and 10 minutesafter intubation were noted. Epi Info 7.2 was used forstatistical analysis. Chi square and ANOVA tests were appliedto compare haemodynamic parameters.Results: 18 patients (51.4%) were CL grade I and 17 (48.6%)were CL grade II in Macintosh, 24 (68.6%) were CL gradeI and 11 (31.4%) were CL II in McCoy and, 32 (91.4%)were CL I and 3 (8.6%) were CL II in Miller group. Risein heart rate following intubation was greatest with Millerblade, followed by Macintosh and least with McCoy, andwas statistically significant (P< 0.01). Rise in both, systolicand diastolic blood pressure following intubation was highestwith the Miller blade, followed by Macintosh and least withMcCoy, and the difference compared with baseline values wasstatistically significant (P<0.01).Conclusions: Miller blade provides best visualization of larynxbut McCoy blade produced least haemodynamic response,hence the latter is preferable when less haemodynamicresponse is desired.

Comparison between Airtraq Optical Laryngoscope and Conventional Macintosh Laryngoscope for Intubation in Adult Surgical Patients: A Prospective Randomized Controlled Study

Introduction: Intubating trachea and securing the airway remain a challenge although it is a routine practice for theanesthesiologist. Failure to successfully intubate the trachea remains a leading cause of morbidity and mortality in anestheticand emergency setting.Aim: This study aims to compare the intubating conditions in adult surgical patients using Airtraq optical laryngoscope withMacintosh laryngoscope with respect to ease of intubation, the time taken for intubation, airway trauma, and hemodynamicresponse to laryngoscopy.Methods: In a single-center, prospective, randomized, parallel group, open-label, interventional study, 40 adult patients postedfor surgery under general anesthesia need of endotracheal intubation were recruited and allocated into two groups: Group A(n = 20) intubated with Airtraq laryngoscope and Group B (n = 20) intubated with conventional Macintosh laryngoscope instandard intravenous induction.Results: Mean duration of intubation with the Airtraq group was 15.93 s, whereas in the Macintosh group, it was found to be38.70 s (P < 0.0001). The increase in mean heart rate from the pre-induction to post-intubation in Airtraq group was 20.9/min,whereas in Macintosh group was 31.9/min. The increase in mean arterial pressure from pre-intubation to post-intubation inAirtraq group was 12.6 mmHg, whereas in Macintosh group was 30.3 mmHg. Three patients in the Macintosh group and twopatients in the Airtraq group experienced trauma to the airways (P = −0.958).Conclusion: A study concluded that endotracheal intubation is easier, less time is taken for intubation, less trauma, and lesshemodynamic response when using Airtraq laryngoscope than Macintosh laryngoscope.

The application of HC visual laryngoscope used for emergency tracheal intubation on obese patients in Emergency Department / 中华急诊医学杂志

Objective To investigate the effect and application value of HC visual laryngoscope used for the emergency tracheal intubation on obese patients in the Emergency Department. Methods Totally 80 obese patients enrolled from January 2014 to December 2016 from Emergency Department, Second affiliated hospital of Xi'an Jiaotong University who needed the emergency tracheal intubation were randomly (random number) divided into two groups. Patients in group T were operated with traditional laryngoscope, and patients in group HC with HC visual laryngoscope. Then the success rate of glottis exposure, the trial times, operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Results The success rate of glottis exposure in group HC was significantly higher than that in group T (95％ vs 77.5％, P<0.05). The one-time success rate of tracheal intubation and the total success rate of tracheal intubation in group HC were significantly higher than those in group T (72.5％ vs 37.5％, and 95％ vs 62.5％, respectively, P<0.05). However, the trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in group T (1.26±0.40) vs (1.64±0.82), and (30.74±6.17) s vs (44.2±7.68) s, respectively, P<0.05. The complication rate of tracheal intubation in group HC was significantly less than that in group T (12.5％ vs 35％, P<0.05). Conclusions HC visual laryngoscope used for the obese patients in Emergency Department can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation, thus having a certain application value.

Successful intubation using video laryngoscope in a child with CHARGE syndrome: A case report

CHARGE syndrome is a rare genetic disorder with CHD7 gene mutation. CHARGE is an acronym for coloboma (C), heart disease (H), atresia of choanae (A), retardation of growth (R), genitourinary malformation (G), and ear abnormalities (E). Patients with CHARGE syndrome need to undergo many surgeries due to their various congenital anomalies. Since airway abnormalities frequently accompany CHARGE syndrome, general anesthesia remains a challenge. Here we report a case of difficult intubation in a 35-month-old boy with CHARGE syndrome during general anesthesia and the experience of successful intubation using D-blade of C-MAC® video laryngoscope.

A Missed and Delayed Detected Fish Bone Impaction in Subglottis / 대한이비인후과학회지

Laryngeal foreign body can be a life-threatening emergency. Respiratory distress, aphonia, and cyanosis may occur in quick succession. However, in case of a non-obstructive laryngeal foreign body, symptoms can be indolent, but the hazardous foreign body can nevertheless put the patient in danger. To prevent life-threatening consequences, early detection based on symptoms is imperative. This case, which presented with usual symptoms of anterior neck pain and throat discomfort without respiratory symptoms and an unusual site of laryngeal foreign body, finally turned out to be an impacted fish bone in the subglottis.

Airtraq Video Laryngoscope for Nasotracheal Intubation in Patients With Obstructive Sleep Apnea and Hyperpnoea Syndrome:Prospective Randomized Controlled Trial / 中国微创外科杂志

Objective To compare the effect of nasotracheal intubation between Airtraq video laryngoscope and Macintosh laryngoscope in patients with obstructive sleep apnea and hyperpnoea syndrome(OSAHS). Methods A total of 60 patients with OSAHS receiving nasotracheal intubation were randomly divided into two groups: the group M was intubated with Macintosh laryngoscope and the group A was intubated with Airtraq video laryngoscope.The blood pressure and heart rate were recorded before induction(T0),before intubation(T1),immediately after intubation(T2),first minute(T3)and fifth minute(T4)after intubation. The intubation time,Cormach-Lehane scale,external laryngeal press,use of magil forceps and the incidence of blood on laryngoscope were recorded. Results The systolic pressure and heart rate at T 2,T3and T4were significantly higher than T1in the group M(P<0.05),but no significant changes were found among T 2,T3and T4in the group A(P>0.05).The systolic pressure was significantly different between the two groups at T 2and T3(P<0.05).The heart rate was significantly different between the two groups at T 2,T3 and T4(P<0.05).The diastolic pressure was not significantly different between the two groups(P >0.05).The laryngoscope exposure scale in the group A was significantly superior to the group M(Z=-4.935,P=0.000).The intubation time in the group A(30.4 ±9.0)s was significantly less than that in the group M[(42.3 ±16.5)s, t =-3.468, P =0.000]. Conclusion Nasotracheal intubation with Airtraq video laryngoscope has less influence on hemodynamics,shorter intubation time and easier performance as compared with Macintosh laryngoscope in patients with OSAHS.

Comparison of domestic video intubationscope and Macintosh direct laryngoscope in nasal intubation / 中国内镜杂志

Objective To compare the clinical effect of nasal intubation with domestic video intubationscope and Macintosh direct laryngoscope. Methods One hundred patients scheduled for oro-maxillo-facial operation, American Society of Anesthesiologists (ASA) grade I or II, aged 19 ~ 67 years, were randomly divided into the domestic video intubationscope group (group V) and the Macintosh direct laryngoscope group (group M), with 50 cases in each group. Nasal intubation was respectively performed with domestic video intubationscope (Group V) and Macintosh direct laryngoscope (group M). Cormark-Lehane grade (C-L classification), tracheal intubation time, first-time intubation success rate and tracheal intubation complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) of before induction of anesthesia (T0), after induction of anesthesia (T1), at glottic exposure (T2), at intubation (T3), 1 min after intubation (T4) and 3 min after intubation (T5) were recorded. Results C-L classification in group V was significantly lower than that in group M (P < 0.05), intubation time in group V was significantly shorter than that in group M (P < 0.05), first-time intubation success rate in group V was significantly higher than that in group M (P < 0.05). Compared with T1, MAP was significantly higher at T3~ T4and HR was significantly faster at T3in group V, MAP was significantly higher at T2~ T4and HR was significantly faster at T2~ T3in group M (P < 0.05). Compared with group M, MAP and HR in group V were significantly lower at T2~ T4 (P < 0.05). The incidence of tracheal intubation complications in group V was significantly lower than that in group M (P < 0.05). Conclusions Compared with Macintosh direct laryngoscope,domestic video intubationscope in nasal intubation is better in glottic exposure,it could shorten tracheal intubation time ,increase first-time intubation success rate, maintain stable hemodynamics, has fewer tracheal intubation complications and is worthy of clinical application.

Curative effect of surgical treatment of vocal cord polyps under the support of laryngoscope / 中国基层医药

Objective To investigate the clinical efficacy of endoscopic surveillance system for operation of vocal cords polyp laryngoscope.Methods From January 2016 to October 2017,the clinical data of 50 patients received polyp of vocal cord surgery by laryngoscope endoscopic monitoring system implementation in Xiaogang Hospital of Beilun District were retrospectively analyzed.The clinical effect was analyzed.Results Of 50 cases,46 cases were cured,the cure rate was 92％,the patients improved in 4 cases,improvement rate was 8％,and there was no invalid patients.Conclusion Laryngoscope combined with endoscopic monitoring has advantages of simple operation,clear lesions location,good treatment effect,not easy to relapse.