L Putz1, G Dangelser, B Constant, J Jamart, E Collard, M Maes, A Mayné. 1. Service d'anesthésiologie, département de médecine aiguë, cliniques universitaires de Mont-Godinne, avenue Therasse-1, 5530 Yvoir, Belgique. laurie.putz@uclouvain.be
Abstract
OBJECTIVES: Videolaryngoscope techniques are more and more in use and tend to modify our approach for patients difficult to intubate. We compared two techniques, Airtraq and Glidescope with direct laryngoscopy, with special emphasis on ease of access to airway (Intubation Difficulty Score - IDS score, duration and success of intubation) and the impact on hemodynamic variables among patients with a BMI of more than 30. STUDY DESIGN: Prospective study randomised with minimisation technique. MATERIAL AND METHODS:Eighty patients have been allocated by minimisation to four groups: two groups being intubated with Airtraq, each one with a different investigator, and two with Glidescope videolaryngoscope technique. Induction of anesthesia was standardly performed with total intravenous anesthesia with remifentanil, propofol in TCI mode and rocuronium in bolus. Following parameters were recorded : intubation success based on intubation time and desaturation level, its duration, its impact on hemodynamic variables, IDS score and possible dental lesions. RESULTS:Intubation success was 100% for Glidescope and 80.6% for Airtraq (P=0.009). Airtraq allowed a better visualisation of the vocal cords (lower Cormack and Lehane score) than Glidescope. In contrast, alternative intubation techniques were significantly more often used in the Airtraq group. No difference could be detected between both systems on hemodynamic parameters. CONCLUSIONS: In obese patients, Glidescope allows intubation relatively easily without rescue techniques.
RCT Entities:
OBJECTIVES: Videolaryngoscope techniques are more and more in use and tend to modify our approach for patients difficult to intubate. We compared two techniques, Airtraq and Glidescope with direct laryngoscopy, with special emphasis on ease of access to airway (Intubation Difficulty Score - IDS score, duration and success of intubation) and the impact on hemodynamic variables among patients with a BMI of more than 30. STUDY DESIGN: Prospective study randomised with minimisation technique. MATERIAL AND METHODS: Eighty patients have been allocated by minimisation to four groups: two groups being intubated with Airtraq, each one with a different investigator, and two with Glidescope videolaryngoscope technique. Induction of anesthesia was standardly performed with total intravenous anesthesia with remifentanil, propofol in TCI mode and rocuronium in bolus. Following parameters were recorded : intubation success based on intubation time and desaturation level, its duration, its impact on hemodynamic variables, IDS score and possible dental lesions. RESULTS: Intubation success was 100% for Glidescope and 80.6% for Airtraq (P=0.009). Airtraq allowed a better visualisation of the vocal cords (lower Cormack and Lehane score) than Glidescope. In contrast, alternative intubation techniques were significantly more often used in the Airtraq group. No difference could be detected between both systems on hemodynamic parameters. CONCLUSIONS: In obesepatients, Glidescope allows intubation relatively easily without rescue techniques.
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