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Abstract
Background The gold quality in patients who are too obese is the endotracheal puzzle that is awake using the fibrous broncoscope. He needs special skills and advanced training. The disposable arteroscopy arteries were used to severely disrupt them. There may be some advantages compared to the fibrous brutoscope during arousal orotracheal implantation.
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Patients and methods
In this study, 60 obese patients were randomly assigned to immune flush with the fiber broncoscope (30 patients) or the Airtraq laryngoscope (30 patients). The time required for implantation, number of induction efforts, success rate, and difficulties in both groups was assessed.
Results
The time required for intubation to be shorter in the Airtraq group was compared to the broncoscope group. In terms of volume, there was an insignificant difference between the two groups. All patients performed well and there were significant difficulties between the two groups.
Conclusion
The Artq laryngoscope can be safely used as the fibrous broncoscope for aroused orotracheal intake in obese obese patients.
Introduction
Obesity is a major challenge for staff in the operating room due to dangers associated with general anesthetic with life-threatening complications, including airway obstruction, rapid de-denomination and aspiration.
Abdominal obesity may be associated with lame sleep apnea and with a large neck circumference with difficult timing.
A difficult airway involves the clinical situation where a trained anesthetist has difficulty with air mask, with tracheal implantation, or both.
The use of fiber bronchoscope gradually increased for difficult tracheal induction. Anesthetists still have limited skills in interfering with fiber awake implantation.
The learning curve for intubation using the fiber broncoscope must always be developed with patients who are normal and considered successful after at least 10 individual attempts to do less than 2 minutes .
Airtraq optical laryngoscope is a device for routine and difficult ingestion. There is a curved blade with two side-by-side ways for endotracheal tube and optical system. This device gives a good illuminated view of the glottis with no more force in place and no need to align the oral, pharmaceutical, and medical axes. Comforting up with Artart can be a reasonable choice for patients with a difficult route.
In this study, we evaluated the difference between awakening implantation using the fibrous bronchoscope or from the artillery in patients who are too obese, and we studied whether an Artq laryngoscope can replace fibrous broncoscope in obese patients .
Patients and methods
This study was carried out on 60 obese patients scheduled for elective surgery under general anesthesia. This study was carried out from March to October 2015 following the approval of the ethical committee and informed consent from patients. Patients aged between 18 and 60 years of both sexes were included with a BMI of 30 kg / m2 or more and grade 3 or 4. A study of patients who refused to participate in the study and non-cooperative patients, such as these, was not issued. Those with mental retardation, lack of communication, blindness, and deafness. We also issued any patients with signs of waking up, rather than morbid obesity, such as oropharyngeal masses, physical status IV or V with the Anesthetists, respiratory tract disorders or coagulation disorders, a requirement in a way nasal for tracheal intake, or risk for redevelopment – Optimization (upper gastrointestinal tract surgery, known hiatus hernia, esophageal reflux, peptic ulceration, or not attached). Finally, exclude impossible anticipated scenarios too.
Patients were randomly classified using opaque closed cover into two identical groups: F group, including patients who were awake intubation with fibrous broncoscope, and group A, including patients who went under awake exploration using the Airtraq .
Technique
The patients’ medical and surgical history was assessed, a clinical examination was carried out and routine laboratory investigations were reviewed. The preliminary visit was made to explain the technique, including steps, benefits, and safety, to ensure that the patient could understand the situation, and to consider the best co-operation. Patients were quickly performed for 8 h for solid food, 6 h for shemisolids, 4 h for non-particulate juice, and 2 h for clear fluids. Antichlogen was given in the form of glycopyrolate at a dose of 0.2 mg intellectually 30 minutes before intubation. The patient was connected to monitors, including oxidation pulse, ECG, and curvature of non-invasive blood pressure. Patients were oxygenated before patients for 5 minutes by face mask at 5-6 l / min and continued during implantation through nasal cannula at 2-3 r / min, and 50-100 mcg fentanyl was given for light seizures. Anesthetics of the oropharynx and the supraglottic region were made using 15 ml lidocaine 2% nebulization for 20 minutes, and 5% gelid lidocaine applied to the base of the tongue using a language blade 2 minutes before manipulation. Anesthesia was tested with a tongue blade and the response was good if there was no discomfort or gag recurrence. For fibrous bronchoscope, the holder was grasped in the mouth and suction was made of the pharynx. The endotracheal tube was lubricated and placed in a grip holder. The fiber scope was introduced through the tube and progressed beyond the epiglottis until the glottis scene was detected and the patient was asked to take a deep breath. The scope was then passed through the vocal cords and promoted to the carina. Subsequently, the endotracheal tube was placed over the fiberscope into the trachea 3 cm above the charina. The fiberscope was then removed smoothly, the tube was fixed, curved inflated, connected to the anesthesia circuit, and stimulated general anesthesia.
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