Discussion
sore throat, glottis, pneumothorax
SORE THROAT, PNEUMOTHORAX, POSTOPERATIVE COMPLICATIONS, COMPLICATION, BLIND, LEAKAGE, COMPLICATIONS
The first-attempt success rate of SaCoVLM insertion was 92.7% (95%CI = 1.03–1.13) in children, which confirms that the success rate of devices insertion is lower than that in adults with normal airway [The SaCoVLM contains a camera to capture the images of the glottis on a screen. We graded the images of 120 patients. Total track mask can visualize the glottis in 83% of patients [The first-attempt success rate of SaCoVLM video laryngeal mask-guided intubation was 91.1% (95%CI = 1.04–1.14). Previous findings that suggest blind intubations through supraglottic airway devices should not be performed in children as epiglottic downfolding may be present [Due to the need of surgery, all LMAs have been withdrawn. It should be noted that the tracheal tuber should not be taken out accidentally when withdrawing LMA. Another reasonable option may be to leave both the ETT and the SaCoVLM in place until the conclusion of the procedure.The most common complication were sore throat (16.1%) and blood staining (31.5%), our rates were higher than those found in a previous study [In this study, the classification of SaCoVLM and FIS is quite different. The reason is that they observe in different sites. For FIS is through the laryngeal mask vent tube to observe the glottis at the end of the vent tube. the SaCoVLM camera is located on the right side of vent cuff, which is prone to the right side of the vent opening end. However this difference does not affect the intubaion process. It was not common that the camera heated up, maybe because the camera was not directly exposed, since the vent opening was a blind end, and we turned on the camera in advance to preheat and put it into the visual channel, and then inserted the LMA .In this study, we excluded three patients. the reasons were as follows (1): after tracheal intubation, air leakage test was positive after inflating the cuff, we supposed there might be a damage on the tube, so we changed a new tube by cook bougie. (2) after tracheal intubation, air leakage test was negative before inflating the cuff, we guessed the tube size might too large for the boy, we changed the tube by using a cook bougie. (3) one boy suffered a pneumothorax after the surgery, which was a postoperative complications after costal cartilage graft performed procedure.This study had several limitations. First, we did not study neonates or children with normal ears, maybe we could cooperate with other institution for further study. Second, the complications such as blood staining of these devices should be studied more detailed. Third, data were collected in an unblinded fashion, which may have introduced bias and age range was wide and associated with anatomical differences in children which may affect the results the scientific basis on which the sample size was determined, we will carry out comparative studies on different models for further study.This single-center study as a initial study, aiming to lay a foundation for the later multi-center large sample study.