Objective To evaluate light-guided tracheal intubation using blind intubation device (BID) in adult patients with temporomandibular joint ankylosis. Methods Twenty adult patients, American Society of Anesthesiologists...Objective To evaluate light-guided tracheal intubation using blind intubation device (BID) in adult patients with temporomandibular joint ankylosis. Methods Twenty adult patients, American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, with temporomandibular joint ankylosis were selected for awake blind nasal intubation. The patients were prepared with nasal decongestants and inhaled 100% oxygen for 3min, then fentanyl (2μg/kg) and midazolam (1-5 mg) were intravenously injected for sedation. Topical anaesthesia for the glottis was performed by using cricothyroid injection of local anaesthesia. A blind intubation device was used to help blind nasal intubation. Three attempts of blind nasal intubation were permitted, otherwise, fiberoptic bronchoscope (FOB) intubation was utilized considering the failure of blind intubation. During the procedure, heart rate, mean arterial pressure, and pulse oxygen saturation (SpO2) were measured. Results Nineteen patients successfully underwent blind nasal intubation by BID. The success ratio for first attempt was only 65.0%, while it reached 95.0% for three attempts. Light-guided catheter failed to be inserted for three attempts in only one patient. However, FOB was successfully used for the first attempt by the same anaesthetist. Conclusion Light-guided tracheal intubation by using blind intubation device is a safe and effective method for blind nasal intubation in the patients with temporomandibular joint ankylosis.展开更多
文摘Objective To evaluate light-guided tracheal intubation using blind intubation device (BID) in adult patients with temporomandibular joint ankylosis. Methods Twenty adult patients, American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, with temporomandibular joint ankylosis were selected for awake blind nasal intubation. The patients were prepared with nasal decongestants and inhaled 100% oxygen for 3min, then fentanyl (2μg/kg) and midazolam (1-5 mg) were intravenously injected for sedation. Topical anaesthesia for the glottis was performed by using cricothyroid injection of local anaesthesia. A blind intubation device was used to help blind nasal intubation. Three attempts of blind nasal intubation were permitted, otherwise, fiberoptic bronchoscope (FOB) intubation was utilized considering the failure of blind intubation. During the procedure, heart rate, mean arterial pressure, and pulse oxygen saturation (SpO2) were measured. Results Nineteen patients successfully underwent blind nasal intubation by BID. The success ratio for first attempt was only 65.0%, while it reached 95.0% for three attempts. Light-guided catheter failed to be inserted for three attempts in only one patient. However, FOB was successfully used for the first attempt by the same anaesthetist. Conclusion Light-guided tracheal intubation by using blind intubation device is a safe and effective method for blind nasal intubation in the patients with temporomandibular joint ankylosis.