• M Weiss, K Hartmann, J Fischer, and A C Gerber.
• Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland. markus.weiss@kispi.unizh.ch
• Can J Anaesth. 2001 Jul 1;48(7):691-6.

PurposeTo evaluate the efficacy of video-intuboscopic assisted tracheal intubation in a difficult intubation setting.MethodsIn 50 pediatric patients (mean age 12.8 +/- 3.1 yr, range 6-16 yr) a grade 3 direct laryngoscopic view was simulated. Eight certified registered nurse anesthetists without experience in endoscopic intubation performed tracheal intubation on five or more patients using the video-optical intubation stylet. Time from insertion of the tube into the oral cavity until the tip had passed the vocal cords was recorded. Failed intubation was defined as intubation >60 sec, arterial oxygen saturation <92% or esophageal intubation. Subjective degree of difficulty was asked from the operators using a Likert-scale.ResultsForty-six of the 50 patients were successfully intubated within 60 sec and without arterial oxygen desaturation. In four patients, video-assisted tracheal intubation failed due to prolonged intubation time. Intubation times ranged from 10-40 sec (median 15 sec). Mean intubation time in the first patient (24.5 +/- 17.3 sec) appeared longer than for the fifth patient (20.8 +/- 10.9 sec), but the difference was not statistically significant (P=0.87). Mean estimated degree of difficulty was 3.9 +/- 2.1. Subjective estimates of difficulty increased with intubation times (P=0.001).ConclusionThe video-optical intubation stylet can be considered a valuable aid for tracheal intubation in pediatric patients with a difficult airway.

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