Analysis of Difficult Tracheal Intubation Based on Video Records Using a Macintosh Type Video Intubating Laryngoscope in Adult


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To assess the incidence of the difficult intubation and evaluate its clinical characteristics, we analyzed 964 cases of video records of tracheal intubation by Macintosh type video laryngoscope (MVL; X-Lite video^[○!R]: Rusch, Germany). The views during the laryngoscopy were recorded on a video system, and the number of intubation attempts and total attempt times were measured afterwards. The video laryngoscope grade (V-grade) was determined based on the Cormack & Lehane grade (C-grade), and its correlation with the Mallampati classes (MP), the number of intubation attempts, and total attempt time were analyzed. V-grade 3 was defined as a difficult intubation, and morphological measurement of the head and neck regions was performed postoperatively. Of the 964 patients, 522, 416, and 26 patients were classified into V-grade 1, 2 and 3, respectively, and the number and time of attempts significantly increased with the grade (p<0.05). The V-grades were significantly correlated with the MP classes and the number and time of attempts (p<0.0001). At least 1 of the 3 morphological measurement items was abnormal in the 26 patients with difficult intubation in visual assistance and recognition. The use of MVL might facilitate difficult intubation. Its video records were useful for analysis. The postoperative morphological feature was consistent with previous reports where MVL was not used.





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