Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.04.027
Brazilian Journal of Anesthesiology
Original Investigation

Comparison of the intubation success rate between the intubating catheter and videolaryngoscope in difficult airways: a prospective randomized trial

Comparação da taxa de sucesso de intubação entre o cateter de intubação e o videolaringoscópio em vias aéreas difíceis: um estudo prospectivo randomizado  

Aysun Ozdemirkan; Ozkan Onal; Irem Gumus Ozcan; Emine Aslanlar; Ali Saltali; Mehmet Sari; Cansu Ciftci; Hasan Huseyin Bayram

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Abstract

Background: Several devices and algorithms have already been examined and compared for difficult airway management. However, there is no existing study comparing the success of the Intubating Catheter (IC) and the Videolaryngoscope (VL) in patients who are difficult to intubate. We aimed to compare Frova IC and McGrath VL in terms of intubation success rates in patients with difficult intubation.

Methods: This prospective, randomized study was performed in an university hospital. Patients who underwent an operation under general anesthesia and whom airway management process was deemed difficult were included in this study. Patients were randomly divided into two groups by envelopes containing a number: the intubating catheter group (Group IC), intubated using the Frova IC, and the videolaryngoscope group (Group VL), intubated using the McGrath VL. Study data were collected by a technician who was blind to the study groups and the type of device used in the intubation procedure.

Results: A total of 49 patients with difficult airway were included in the study, including 25 patients in the Frova IC Group and 24 patients in the McGrath VL Group. The rate of successful intubation was determined to be 88% in Group IC and 66% in Group VL (p = 0.074). The mean duration of intubation attempt in Group VL was 44.62 seconds, whereas in Group IC, it was 51.12 seconds (p = 0.593). Group VL was found to have a significantly lower Cormack-Lehane grade compared to Group IC (p < 0.001).

Conclusion: Frova IC is a candidate to be an indispensable instrument in terms of cost-effectiveness in clinics such as anesthesia and emergency medicine, where difficult intubation cases are frequently encountered. However, the combination of Frova IC and McGrath VL seems to be more successful in difficult intubation situations, so future studies should focus on using these two devices together.

Keywords

Airway management, Catheters, Equipment and supplies, Intubation, Intratracheal

Resumo

Introdução: Vários dispositivos e algoritmos já foram examinados e comparados para o manejo de vias aéreas difíceis. No entanto, não existe estudo comparando o sucesso do Cateter de Intubação (CI) e do Videolaringoscópio (VL) em pacientes de difícil intubação. Nosso objetivo foi comparar o CI Frova e o VL McGrath em termos de taxas de sucesso de intubação em pacientes com intubação difícil.

Métodos: Estudo prospectivo e randomizado realizado em um hospital universitário. Pacientes operados sob anestesia geral e cujo manejo das vias aéreas foi considerado difícil foram incluídos neste estudo. Os pacientes foram divididos aleatoriamente em dois grupos por envelopes contendo um número: o grupo cateter de intubação (Grupo CI), intubado com o CI Frova, e o grupo videolaringoscópio (Grupo VL), intubado com o VL McGrath. Os dados do estudo foram coletados por um técnico que desconhecia os grupos de estudo e o tipo de dispositivo utilizado no procedimento de intubação.

Resultados: Um total de 49 pacientes com via aérea difícil foram incluídos no estudo, incluindo 25 pacientes no Grupo CI Frova e 24 pacientes no Grupo VL McGrath. A taxa de intubação bem-sucedida foi determinada em 88% no Grupo IC e 66% no Grupo VL (p = 0,074). O tempo médio de tentativa de intubação no Grupo VL foi de 44,62 segundos, enquanto no Grupo CI foi de 51,12 segundos (p = 0,593). O Grupo VL apresentou um grau de Cormack-Lehane significativamente menor em comparação ao Grupo CI (p <0,001).

Conclusão: CI Frova é candidato a instrumento indispensável em termos de custo-efetividade em clínicas como anestesia e medicina de emergência, onde casos difíceis de intubação são frequentemente encontrados. No entanto, a combinação de CI Frova IC e VL McGrath parece ter mais sucesso em situações de intubação difíceis, portanto, estudos futuros devem se concentrar no uso desses dois dispositivos juntos.

Palavras-chave

Manejo das vias aéreas, Cateteres, Equipamentos e suprimentos, Intubação, Intratraqueal

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Submitted date:
10/17/2019

Accepted date:
04/25/2021

60b0f1a5a953955ab2007e83 rba Articles

Braz J Anesthesiol

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