Factors Affecting on Intubation Techniques Selection on Patients with Deep Neck infection (DNI) under general Anesthesia at Buri Ram Hospital
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Abstract
Background: The choice of airway care in patients with deep neck infection who undergo surgical drainage under a general anesthesia is very important for the management, however, there is no suitable guideline.
Objective: To investigate the factors affecting on intubation technique selection in patients with deep neck infection who undergo surgical drainage under a general anesthesia.
Methods: This was a retrospective study carried out on patients with deep neck infection who undergo surgical drainage under a general anesthesia at Buriram Hospital from 2017 to 2019. All patients were 18 years old or older. The general analysis used descriptive statistics and percentage. Chi-square test was used to determine the relationships of the factors that have an effect on choosing endotracheal intubation technique. The result will be considered statistically significant when P-value < 0.05.
Results: A total of 85 patients were enrolled in this study, 53 (61.6%) were male. Intubation techniques used in this study were fiberoptic intubation, which was used in 30 cases (35.5%), Macintosh intubation in 19 cases (22.4%), Mccoy intubation in 19 cases (22.4%), and Video laryngoscope intubation in 17 cases (20%). Signs, symptoms and American Society of Anesthesiologists (ASA) physical status that were associated with fiberoptic intubation technique selection were dyspnea, hoarseness of voice, floor of mouth swelling, stridor, and ASA physical status class 3 (P-value = 0.015, < 0.001, 0.004, 0.030 and 0.007 respectively). Moreover, we found that Ludwig’s angina position (P-value = 0.004) and the amount of infected spaces of multiple-space infections (P-value < 0.001) were also associated with fiberoptic intubation technique selection. Single-space infection (P-value < 0.001) was also associated with Macintosh intubation technique selection.
Conclusion: Factors that were associated with fiberoptic intubation technique selection in patients with deep neck infection were dyspnea, hoarseness of voice, floor of mouth swelling, stridor, Ludwig’s angina position, multiple-space infection, and ASA physical status class 3 . The factor that was associated with Macintosh intubation technique selection is single-space infection.
Keywords: anesthetic, deep neck infection, endotracheal intubation
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References
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