Comparison of three differnt techniques for management of difficult intubation

ABSTRACT

This study was carried out in Alexandria Main University Hospital to evaluate 3 different techniques for management of difficult air way Thirty adult patients with expected difficult airway were categorized into 3 groups [10 patients each]. Patients of group 1 were managed with blind nasotracheal intubation technique, patients of group II were managed with Mc Coy laryngescope, and patients of group III were managed with the intubating laryngeal mask airway [lLMA-Fastrach]. All patients received general anaesthesia before management of the airway with the chosen technique. The parameters recorded included number of intubation trials, incidence of failure and time to achieve satisfactory ventilation Also, haemadynamic and ventilatory parameters were recorded. Our results showed that group III [Fastrach] had the highest success rate for intubation together with the least changes in ventilatory parameters during the procedure. However, group I had the highest failure rate for intubation [30%] followed by McCoy laryngescope [20%]. Also blind nasotracheal intubation technique was accompanied by the highest incidence of changes in ventiiatory parameters and complications during the technique. In conclusion, the study showed that ILMA is a potential aid for management of difficult airway as it has the advantages of high incidence of success and the unique ability to maintain ventilation during trails of tracheal intubation. Also, blind nasal intubation and McCoy laryngoscope still have a considerable role for management of difficult airway