Shikani Optical Stylet–guided Intubation via the Intubating Laryngeal Airway in Patients With Scar Contracture of the Face and Neck

Objective To evaluate the feasibility of the Shikani Optical Stylet （SOS）-guided inmbation through a new Intubafing Laryngeal Airway （ILA） in anticipated difficult airways caused by scar contracture of the face and neck. Methods Thirty-three adult patients with anticipated difficult airways undergoing selective faciocervical scar plastic surgery under general anesthesia were enrolled in this study. After anesthesia induction, a size 2.5, 3.5 or 4.5 ILA was inserted. Following good lung ventilation being verified, the SOS preloaded with an endotracheal tube was inserted via the ILA. Once the clear vocal cords came into view under the SOS, the endotracheal tube was advanced through glottis into the trachea. Results The ILA provided an effective airway in all patients, lntubation was successful at the first attempt on 22/33 （66.7%） occasions and at the second attempt on 6/33 （18.2%）. Intubation failed in 5 （15.1%） patients who suffered from severe limitation of head extension due to scar contracture of the neck. These patients＇ tracheas were finally intubated using a fibreoptic bronchoscope via the ILA. Conclusions The SOS-guided intubating method via the ILA is a feasible technique in patients with scar contracture of the face and neck. However, in patients with severe limitation of head extension, the use of SOS cannot be recommended. The SOS can be used as an alternative apparatus when the fibreoptic bronchoscope is not available.

Comparison of endotracheal intubation with the Shikani Optical Stylet using the left molar approach and direct laryngoscopy

The Shikani Optical StyletTM or SOS （Clarus Medical, USA） was developed as an aid to intubation for difficult airways.^1 The-SOS is composed of a J-shaped malleable body and a lens and light source at the tip and an eyepiece at the proximal end. It combines the features of a fiberoptic bronchoscope and a lightwand. It can be used alone or combined with a camera or monitor and both adult and pediatric versions are available.^2.3

视可尼可视喉镜与普通喉镜对高血压患者气管插管血流动力学和应激反应的比较

目的:观察视可尼可视喉镜与普通喉镜对高血压患者气管插管血流动力学和应激反应的影响。方法:择期经口气管插管全麻下拟行非心脏手术的高血压Ⅰ-Ⅱ级患者80例,ASAⅠ-Ⅱ级,随机分为两组,每组40例。N组(普通喉镜组),G组(视可尼可视喉镜组),术前血压基本控制在正常或临界高值。监测插管时间S(从喉镜片进入口腔到气管导管置入到合适深度的时间),麻醉诱导前(基础值T0),插管即刻(T1),插管后1 min(T2),3 min(T3),5 min(T4),10 min(T5)时的血压(BP)、心率(HR)、二重指数(RPP),并分别在麻醉诱导前(基础值T0),插管后10 min(T5),插管后60 min(T6),采集肘静脉血测定血液中皮质醇的浓度。结果:插管时间G组长于N组(P<0.05)。BR、HR、RPP与基础值相比,T1、T2、T3时两组均有较大幅度的增加,且G组<N组(P<0.05),T4、T5时两组变化幅度都不大,且组间无统计学差异(P>0.05)。两组的皮质醇浓度在T5、T6与T0时刻相比,均明显升高,且G组升高幅度<N组(P<0.05)。结论:与普通喉镜相比,高血压患者采用视可尼可视喉镜经口气管插管所导致的应激反应较小,血流动力学更平稳,但插管时间无明显缩短。