Does the incidence of sore throat postoperatively increase with the use of a traditional intubation blade or the GlideScope? - 12/11/15
: Assistant Professor of Anesthesiology, Jason Ngo, BS b : Medical Student, 4th year, Vadim Vaisman, DO a : Assistant Professor of Anesthesiology, Caroline Daly, MD a : Resident in Anesthesiology, Ashar Ata, MBBS, MPH c : Staff Statistician, Michael Sandison, MD a : Professor of Anesthesiology, Kevin Roberts, MD a : ChairAbstract |
Study Objective |
The GlideScope video-guided laryngoscope is an alternative standard of care for rescue laryngoscopies when direct laryngoscopy is unsuccessful. During postoperative checks by an anesthesiologist, it was noticed that patients who reported sore throat often required GlideScope laryngoscopy. Consequently, it is difficult to determine whether postoperative sore throats are caused by irritation inflicted by multiple laryngoscopic attempts or the actual utilization of the GlideScope itself. The goal of this study was to determine whether the use of the GlideScope leads to a greater or lesser incidence of sore throat when compared with traditional laryngoscope blades used for intubation.
Design |
Eligible patients scheduled for elective inpatient surgeries requiring endotracheal tube intubation were enrolled into this single-blinded prospective cohort study. χ2 Test, Fisher exact test, and t tests were used to compare differences across the primary end point and other demographic categories.
Setting |
Operating rooms and postanesthesia recovery unit, Albany Medical Center, Albany, NY.
Patients |
There were a total of 151 patients with American Society of Anesthesiologists grades 1 to 3 included in the study.
Interventions |
Eighty-one patients were randomized to a control group that received traditional laryngoscopy via Macintosh/Miller blades and 70 patients received video-guided intubation via the GlideScope.
Measurements |
The incidence of postoperative sore throat was recorded via a yes/no questionnaire within 24 hours after extubation. Secondary parameters such as provider type, sex, and perceived difficulty were also recorded.
Main results |
There was no significant difference in the proportion of patients reporting sore throat by type of blade used (Mac/Miller 36.3% vs GlideScope 32.4%, P = .619). For secondary outcomes, women were significantly more likely to report sore throat as compared with men (men 24.3% vs women 43.2%, P = .015), and the provider type was significantly associated with the occurrence of postoperative sore throat (attendings 26.8% vs certified registered nurse anesthetists 52.3% vs third-year clinical anesthesia residents 30%, P = .012).
Conclusions |
Use of the GlideScope videolaryngoscopy was not significantly associated with increased occurrence of postoperative sore throat when compared with traditional intubation techniques. Our results may enable more trainees to acquire intubation skills with the GlideScope during an initial intubation attempt in patients with American Society of Anesthesiologist grades 1 to 3, with optimization of patient satisfaction in respect to postoperative sore throats. In addition, a provider's choice of intubation technique based on either Macintosh/Miller blades or the GlideScope does not significantly impact a patient's risk of postoperative sore throat.
Le texte complet de cet article est disponible en PDF.Keywords : GlideScope, Macmiller, Macintosh, Intubation, Sore throat, Pharyngitis, Postoperative, Endotracheal tube
Plan
| ☆ | Contribution: Dennis J. Cirilla II and Vadim Vaisman helped design the study, conduct the study, collect data, and prepare the manuscript. Jason Ngo and Caroline Daly helped conduct the study, collect data, analyze data, and prepare the manuscript. He is the archival author. Ashar Ata helped analyze data and perform statistical support. Michael Sandison helped provide manpower and resources. Kevin Roberts helped conduct the study. |
| ☆☆ | Attestation: Dennis J. Cirilla II and Vadim Vaisman approved the final manuscript. In addition, they attest to the integrity of the original data and the analysis reported in this manuscript. |
| ★ | Conflicts of interest: None for all authors. |
| ★★ | Funding: Internally funded by the Department of Anesthesiology, Albany Medical Center, Albany, NY. |
| ☆☆☆ | Did a Section Editor solicit this submission? No. |
| ☆☆☆☆ | IRB: Margo Fairbairn-Newton, IRB Administrator, Institutional Review Board, Albany Medical Center, 43 New Scotland Avenue, R-102, Albany, NY 12208. Tel.: 518-262-5997. fairbam1@mail.amc.edu |
Vol 27 - N° 8
P. 646-651 - décembre 2015 Retour au numéro
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