Reducing the risks of laryngoscopy in anaesthetised infants

We have evaluated the use of oxygen insufflation during laryngoscopy with an Oxyscope laryngoscope blade compared to conventional laryngoscopy for maintenance of transcutaneous PO2 during intubation of anaesthetised, spontaneously breathing infants. Twenty healthy children aged between 1 and 24 months were anaesthetised with halothane in oxygen. Laryngoscopy and intubation were performed in a double-blind fashion using a Miller No. 1 Oxyscope blade either with or without oxygen insufflation. Transcutaneous oxygen tension, arterial pressure and heart rate were measured before and after laryngoscopy, and duration of laryngoscopy was recorded. Transcutaneous oxygen tension decreased by 7.1% (SD 6.1%) when oxygen insufflation was used, compared to 33.0% (SD 15.1%) without oxygen insufflation (p less than 0.0001). There were no significant differences in mean duration of laryngoscopy or patient age. We conclude that oxygen insufflation during laryngoscopy and intubation of spontaneously breathing, anaesthetised infants effectively minimises the decrease in transcutaneous oxygen tension from pre-laryngoscopy levels, and makes instrumentation of the airway safer.