Abstract: Objective To compare the effect of Airtraq laryngoscope combined with gum elastic bougie(GEB) and fiberoptic bronchoscope(FOB) in expected difficult airway for bronchial intubation. Methods Forty eight patients scheduled for chest surgery with elective right one-lung ventilation, with gape dim over 3 cm, of Mallampati physical status Ⅲ or Ⅳ, were randomly assigned into 2 groups (n=24): Airtraq laryngoscope combined with gum elastic bougie group (group A) and fiberoptic bronchoscope group (group F). The achievement ratio of first intubation, intubation time, bronchial positioning time, occurrence of airway injury were recorded respectively. SBP, DBP, HR, and plasma level of norepinephrine (NE) were also recorded or measured before anesthesia induction and 2 min after bronchial positioning. Results There was no significant difference in the achievement ratio of first intubation between two groups(91.7% vs 95.8%, P>0.05). The intubation time was shorter in group A than that in group F [(91±17) s vs (105±19) s, P<0.05]. The bronchial positioning time was longer in group A than that in group F [(132±34) s vs (55±12) s, P<0.05]. There was no significant difference in occurrence of airway injury between two groups(P>0.05). Compared with that before anesthesia induction, SBP, DBP, HR, and plasma level of NE at 2 min after bronchial positioning increased significantly(P<0.05). Conclusions Airtraq laryngoscope combined with gum elastic bougie is as safe and helpful as fiberoptic bronchoscope in difficult airway management for bronchial intubation. However, it is with a longer bronchial positioning time and elicits significant cardiovascular stress response.
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