BACKGROUND AND OBJECTIVE:Tracheal intubation may be more difficult in morbidly obese patients (body mass index >35 kg m(-2)) than in the non-obese. Recently, new video-assisted intubation devices have been developed. After some experience with videolaryngoscopy, we hypothesized that it could improve the laryngoscopic view in this specific population and therefore facilitate intubation. The aim of this study was to assess the benefit of a videolaryngoscope on the grade of laryngoscopy in morbid obesity. METHODS: We studied 80 morbidly obese patients undergoing bariatric surgery. They were randomly assigned to one of two groups. One group was intubated with the help of the videolaryngoscope and in the control group the screen of the videolaryngoscope was hidden to the intubating anaesthesiologist. The primary end-point of the study was to assess in both groups the Cormack and Lehane direct and indirect grades of laryngoscopy. The duration of intubation, the number of attempts needed as well as the minimal SPO2 reached during the intubation process were measured. RESULTS:Grade of laryngoscopy was significantly lower with the videolaryngoscope compared with the direct vision (P < 0.001). When the grade of laryngoscopy was higher than one with the direct laryngoscopy (n = 30), it was lower in 28 cases with the videolaryngoscope and remained the same only in two cases (P < 0.001). The minimal SPO2 reached during the intubation was higher with the videolaryngoscope but it did not reach statistical significance. CONCLUSIONS: In morbidly obese patients, the use of the videolaryngoscope significantly improves the visualization of the larynx and thereby facilitates intubation.
RCT Entities:
BACKGROUND AND OBJECTIVE: Tracheal intubation may be more difficult in morbidly obesepatients (body mass index >35 kg m(-2)) than in the non-obese. Recently, new video-assisted intubation devices have been developed. After some experience with videolaryngoscopy, we hypothesized that it could improve the laryngoscopic view in this specific population and therefore facilitate intubation. The aim of this study was to assess the benefit of a videolaryngoscope on the grade of laryngoscopy in morbid obesity. METHODS: We studied 80 morbidly obesepatients undergoing bariatric surgery. They were randomly assigned to one of two groups. One group was intubated with the help of the videolaryngoscope and in the control group the screen of the videolaryngoscope was hidden to the intubating anaesthesiologist. The primary end-point of the study was to assess in both groups the Cormack and Lehane direct and indirect grades of laryngoscopy. The duration of intubation, the number of attempts needed as well as the minimal SPO2 reached during the intubation process were measured. RESULTS: Grade of laryngoscopy was significantly lower with the videolaryngoscope compared with the direct vision (P < 0.001). When the grade of laryngoscopy was higher than one with the direct laryngoscopy (n = 30), it was lower in 28 cases with the videolaryngoscope and remained the same only in two cases (P < 0.001). The minimal SPO2 reached during the intubation was higher with the videolaryngoscope but it did not reach statistical significance. CONCLUSIONS: In morbidly obesepatients, the use of the videolaryngoscope significantly improves the visualization of the larynx and thereby facilitates intubation.
Authors: J Adam Law; Natasha Broemling; Richard M Cooper; Pierre Drolet; Laura V Duggan; Donald E Griesdale; Orlando R Hung; Philip M Jones; George Kovacs; Simon Massey; Ian R Morris; Timothy Mullen; Michael F Murphy; Roanne Preston; Viren N Naik; Jeanette Scott; Shean Stacey; Timothy P Turkstra; David T Wong Journal: Can J Anaesth Date: 2013-10-17 Impact factor: 5.063