Indirect versus direct laryngoscopy for routine nasotracheal intubation - 02/08/11
: Staff Anesthesiologist, Lukas Drabauer, MD, MBA a : Resident in Anesthesia, Klemens Kern, MD a : Resident in Anesthesia, Charlotte Mayer, MD a : Staff Anesthesiologist, Jan Bierbaumer, MD a : Staff Anesthesiologist, Peter H. Rehak, PhD b : Associate Professor, Hans Gombotz, MD a : Associate ProfessorAbstract |
Study Objective |
To compare the effectiveness of the indirect laryngoscopes, Airtraq (A) and GlideScope (G), with the Macintosh (M) laryngoscope in routine nasotracheal intubation.
Design |
Randomized, single-blinded study.
Setting |
University-affiliated, tertiary-care hospital.
Patients |
62 adult, ASA physical status 1 and 2 patients with normal airways requiring nasotracheal intubation for dental or maxillofacial surgery.
Intervention |
Patients in Groups A and G underwent nasal intubation with the Airtraq and GlideScope, respectively, while laryngoscopy in Group M was performed with the Macintosh blade.
Measurements |
Performance of the intubating tools was judged by the ease [Intubation Difficulty Scale (IDS) and numeric rating scale (NRS)] and time to intubation (laryngoscopy and endotracheal tube advancement). In addition, hemodynamic parameters, severity of postoperative sore throat, and posture of the intubator were recorded.
Main Results |
IDS score was significantly lower with the Airtraq and GlideScope than with the Macintosh laryngoscope (mean ± SD: A 0.1 ± 0.3, G 0.3 ± 0.6, M 0.8 ± 1.0; P = 0.013). NRS reported by the intubators showed a similar preference for indirect over direct laryngoscopy (A 0.9 ± 0.7, G 1.1 ± 0.6, M 1.9 ± 1.1; P = 0.001). Duration of laryngoscopy and endotracheal tube insertion was similar in all groups. No significant intergroup differences in hemodynamic parameters were recorded. Postoperative sore throat was significantly reduced using the GlideScope compared with the other devices (P = 0.048).
Conclusion |
The Airtraq and GlideScope facilitated nasotracheal intubation more so than the Macintosh laryngoscope in adults with apparently normal airways.
Le texte complet de cet article est disponible en PDF.Keywords : Airway management, Anesthetic techniques, Laryngoscopy, Equipment, Airtraq, GlideScope, Macintosh laryngoscope, Intubation, Nasotracheal, Laryngoscopy, Larynx
Plan
| ☆ | The authors have no conflicts of interest to report. |
| ☆☆ | Support: departmental funding only. |
Vol 23 - N° 4
P. 280-285 - juin 2011 Retour au numéro
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