دورية أكاديمية
Clinical assessment of awake endotracheal intubation using the lightwand technique alone in patients with difficult airways
| العنوان: | Clinical assessment of awake endotracheal intubation using the lightwand technique alone in patients with difficult airways |
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| المؤلفون: | Xue Fu-shan, He Nong, Liao Xu, Xu Xiu-Zheng, Xu Ya-chao, Yang Quan-yong, Luo Mao-ping, Zhang Yan-ming |
| المساهمون: | Xue, FS (reprint author), Chinese Acad Sci, Dept Anesthesiol, Plast Surg Hosp, Beijing 100144, Peoples R China., Chinese Acad Sci, Dept Anesthesiol, Plast Surg Hosp, Beijing 100144, Peoples R China., Peking Union Med Coll, Beijing 100144, Peoples R China., Peking Univ, Shougang Hosp, Dept Anesthesiol, Beijing 100144, Peoples R China. |
| المصدر: | SCI |
| بيانات النشر: | Chinese Medical Journal |
| سنة النشر: | 2009 |
| المجموعة: | Peking University Institutional Repository (PKU IR) / 北京大学机构知识库 |
| مصطلحات موضوعية: | difficult airways, airway topical anesthesia, awake endotracheal intubation, lightwand technique, LARYNGEAL MASK AIRWAY, FIBEROPTIC INTUBATION, TRACHEAL INTUBATION, TOPICAL ANESTHESIA, NASOTRACHEAL INTUBATION, DIRECT LARYNGOSCOPE, LOCAL-ANESTHESIA, OROTRACHEAL INTUBATION, HEMODYNAMIC-RESPONSES, GENERAL-ANESTHESIA |
| الوصف: | Background There is few study to determine whether the use of the lightwand technique alone could achieve effective, safe and successful awake endotracheal intubation (ETI), therefore we designed a prospective clinical study to systematically evaluate the feasibility, safety and efficacy of awake ETI using the lightwand alone in patients with difficult airways. Methods Seventy adult patients with difficult airways were enrolled in this study. After the desired sedation with fentanyl and midazolam, airway topical anesthesia was performed with 9 ml of 2% lidocaine, which were in order sprayed in three aliquots at 5 minutes intervals into the supraglottic (two doses) and laryngotracheal areas (one dose) using a combined unit of the lightwand and MADgic (R) atomizer. After airway topical anesthesia, awake ETI was performed using a Lightwand. Subjective assessments by patients and operators using the visual analogue scores (VAS), and objective assessments by an independent investigator using patients' tolerance and reaction scores, coughing severity, intubating conditions and cardiovascular variables were taken as the observed parameters. Results Of 210 airway sprays, 197 (93.8%) were successfully completed on the first attempt. The total time for airway spray was (14.6 +/- 1.5) minutes. During airway topical anesthesia, the average patients' tolerance scores were 1.7-2.3. After airway topical anesthesia, the mean VAS for discomfort levels that the patients reported was 6.5. Also airway topical anesthesia procedure was rated as acceptable and no discomfort by 94.3% of patients. The lightwand-guided awake ETI was successfully completed on first attempt within 29 seconds in all patients. During awake ETI, patients' reaction and coughing scores were 1.9 and 1.6, respectively. All patients exhibited excellent or acceptable intubating conditions. Cardiovascular monitoring revealed that changes of systolic blood pressure and heart rate at each stage of airway manipulations were less than 20% of baseline values. The ... |
| نوع الوثيقة: | journal/newspaper |
| اللغة: | English |
| تدمد: | 0366-6999 |
| العلاقة: | CHINESE MEDICAL JOURNAL.2009,122,(4),408-415.; 940921; http://hdl.handle.net/20.500.11897/396682Test; WOS:000263739000010 |
| DOI: | 10.3760/cma.j.issn.0366-6999.2009.04.0010 |
| الإتاحة: | https://doi.org/20.500.11897/396682Test https://doi.org/10.3760/cma.j.issn.0366-6999.2009.04.0010Test https://hdl.handle.net/20.500.11897/396682Test |
| رقم الانضمام: | edsbas.FB55DA68 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 03666999 |
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| DOI: | 10.3760/cma.j.issn.0366-6999.2009.04.0010 |