Clinical efficacy of visual laryngoscope versus visual mouldable light bar for tracheal intubation in patients with nasopharyngeal carcinoma after radiotherapy
Objective To compare the clinical efficacy of visual laryngoscope with visual mouldable light bar in tracheal intubation in patients with nasopharyngeal cancer after radiotherapy.Methods Sixty nasopharyngeal cancer patients aged 18-60 years who underwent elective necrotic tissue debridement or cervical lymph node dissection under general anesthesia with tracheal intubation from October 2019 to May 2021 at Eye & ENT Hospital of Fudan University were selected.They were randomly divided into visual laryngoscope group and visual mouldable light bar group(n=30)according to random number table method.The general information(age,gender composition,BMI,mouth opening,Mallampati classification,nail-chin distance),overall success rate of intubation,success rate of intubation at the first attempt,time of tracheal intubation,haemodynamic indexes(heart rate and mean arterial pressure[MAP])before induction of anesthesia(T0),immediately after induction(T1),immediately after tracheal intubation(T2)and 3 min after intubation(T3)were compared between the two groups.Intubation-related complications(gingival oozing,upper lip bleeding,pharyngeal oozing,choking,oropharyngeal injury,tooth loss,and bronchospasm)were recorded.Results There were no significant differences in the age,gender composition,BMI,mouth opening,Mallampati classification or nail-chin distance between the two groups(all P＞0.05).The overall success rate of intubation in the visual mouldable light bar group was significantly higher than that in the visual laryngoscope group(P＜0.05).The time of tracheal intubation in the visual mouldable light bar group was significantly longer than that in the visual laryngoscope group(P＜0.05).The success rate of intubation at the first attempt in the visual mouldable light bar group was slightly higher than that in the visual laryngoscope group,but the difference was not statistically significant(P＞0.05).The heart rate and MAP at T2 were significantly higher than those at T0 in the same group(all P＜0.05).The heart rate in the visual mouldable light bar group was significantly lower than that in the visual laryngoscope group at T2(P＜0.05).The incidence of gingival bleeding in the visual laryngoscope group was significantly higher than that in the visual mouldable light bar group(P＜0.05),but there was no significant difference in the incidence of upper lip bleeding or pharyngeal oozing between the two groups(all P＞0.05).Conclusion The visual mouldable light bar has less impact on oropharyngeal injury and haemodynamics when tracheal intubation is performed in patients with nasopharyngeal carcinoma after radiotherapy.However,tracheal intubation with visual laryngoscope will take shorter time and be easier to observe the glottic edema and assess safety of extubation.
Video laryngoscopeVisual mouldable light barDifficult airway
万方数据
维普
