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Bangarwa N, Vashishth S, Kumar V, Kumar P, Gehlaut P. Role of Endotracheal Tube Cuff Deflation in Facilitating Passage of Nasogastric Tube. Cureus 2022; 14:e28668. [PMID: 36196284 PMCID: PMC9525043 DOI: 10.7759/cureus.28668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
Abstract
Background Nasogastric tube insertion is a routinely performed technique in anesthetized and intubated patients. However, failure leads to repeated insertion attempts causing injury, which makes the situation cumbersome. Therefore, we introduce a simple technique of deflating endotracheal tube cuff for nasogastric tube insertion in such patients. Methods Eighty adult patients scheduled for elective abdominal surgeries were randomly allocated into two groups, Group A (nasogastric tube insertion without endotracheal cuff deflation) and Group B (nasogastric tube insertion with endotracheal tube cuff deflation) along with lateral pressure application at cricoid in both groups. The number of attempts required, overall success rate, the time taken, rescue maneuvers, and incidence of complications were compared between the groups. Results In Group B, the total success rate for nasogastric tube placement was significantly higher than in Group A (80% vs 55%, p=0.016). Group B had a 55% first attempt success rate, but only 25% of patients in Group A had a first attempt success rate (p=0.014). The overall time for successful nasogastric tube placement was longer in Group A than in Group B (65.4 ± 28.72 seconds vs 43.5 ± 25.37 seconds, p=0.0005). The differences in nasogastric tube kinking and coiling between Group B and Group A were not statistically significant (20% vs 22.5%, 10% vs 27.5%, p = 0.78 and 0.08, respectively). Mucosal bleeding was substantially higher in Group A than in Group B (30% vs 10%, p=0.025, respectively). Conclusions This study showed that endotracheal tube deflation significantly increased the first-attempt success rate, overall successful placement of the nasogastric tube in intubated patients, and incidence of complications like mucosal bleeding decreased.
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Lin CH, Tseng KY, Su MP, Chuang WM, Hu PY, Cheng KI. Cuff inflation technique is better than Magill forceps technique to facilitate nasotracheal intubation guiding by GlideScope® video laryngoscope. Kaohsiung J Med Sci 2022; 38:796-803. [PMID: 35652136 DOI: 10.1002/kjm2.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 11/08/2022] Open
Abstract
Video laryngoscopy is often selected to assist nasotracheal intubation in allowing better laryngeal visualization, although there is no comparative study evaluating the effectiveness between auxiliary techniques by using Magill forceps and inflated cuff in GlideScope video laryngoscopy for nasotracheal intubation. Fifty-one of 100 patients in a Magill forceps group and 47 of 100 patients in a cuff inflation group were included in the final analysis in this randomized, single-blind, parallel, clinical trial study. Induction agents were routinely administered according to body weight, while intubation time spent, attempts, and related side effects were recorded. Compared to the Magill forceps group, the cuff inflation technique shortened the total intubation time (70.0 ± 24.5 s vs. 87.0 ± 25.0 s, p = 0.001) and the time of advancing the nasotracheal tube from oropharyngeal space into the trachea (25.9 ± 16.4 s vs. 42.3 ± 21.2 s, p < 0.001). However, the number of intubation attempts was not significantly different between groups. During tube advancement, the tube was rotated to accommodate the glottis and trachea more frequently in the cuff inflation group (p = 0.009), but the blade of the laryngoscope shifted and was adjusted to the proper position more frequently in the Magill forceps group (p < 0.001). In the Magill forceps group, the tube cuff might be clipped incidentally and the intubator might shift their gaze away from the screen during intubation, although there was no significant difference in intubation-related side effects between groups. Unlike the conventional approach, nasotracheal intubation with the GlideScope® video laryngoscope using the auxiliary technique of cuff inflation could be more suited than using Magill forceps.
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Affiliation(s)
- Chia-Heng Lin
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuang-Yi Tseng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Pei Su
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Ming Chuang
- Department of Anesthesiology, Qishan Hospital of the Ministry of Health and Welfare, Kaohsiung, Taiwan
| | - Ping-Yang Hu
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Airtraq® versus GlideScope® for tracheal intubation in adults: a systematic review and meta-analysis with trial sequential analysis. Can J Anaesth 2022; 69:605-613. [DOI: 10.1007/s12630-022-02217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022] Open
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Tsukamoto M, Taura S, Kadowaki S, Hitosugi T, Miki Y, Yokoyama T. Risk Factors for Postoperative Sore Throat After Nasotracheal Intubation. Anesth Prog 2022; 69:3-8. [PMID: 36223193 PMCID: PMC9552625 DOI: 10.2344/anpr-69-01-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 12/17/2021] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Postoperative sore throat is relatively frequent complication after orotracheal intubation. However, there are few reports about postoperative sore throat in nasotracheal intubation. In this retrospective study, we investigated the risk factors of postoperative sore throat in nasotracheal intubation. METHODS Anesthesia records of patients 16 to 80 years of age who underwent nasotracheal intubation were included. Patients underwent oral and maxillofacial surgery from February 2015 until September 2018. Airway device (Macintosh laryngoscope, Pentax-AWS, or McGRATH video laryngoscope, or fiberoptic scope), sex, age, height, weight, American Society of Anesthesiologists classification, intubation attempts, duration of intubation, intubation time, tube size, and fentanyl and remifentanil dose were investigated. Fisher exact test, Wilcoxon rank sum test, Welch t test, and Steel-Dwass multiple test were used, and a multivariable analysis was performed using stepwise logistic regression to determine the risk factors of postoperative sore throat. RESULTS A total of 169 cases were analyzed, and 126 patients (74.6%) had a postoperative sore throat. Based on the univariate analysis of the data, 12 factors were determined to be potentially related to the occurrence of a postoperative sore throat. However, after evaluation using stepwise logistic regression analysis, the 2 remaining variables that correlated with postoperative sore throat were airway device (P < .05) and intubation attempts (P = .04). In the model using logistic regression analysis, the fiberoptic scope had the strongest influence on the incidence of sore throat with reference to Pentax-AWS (odds ratio = 5.25; 95% CI = 1.54-17.92; P < .05). CONCLUSION Use of a fiberoptic scope was identified as an independent risk factor for postoperative throat discomfort. Compared with direct laryngoscopy and other video laryngoscopes, the use of a fiberoptic scope had a significantly higher incidence of sore throat.
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Affiliation(s)
- Masanori Tsukamoto
- Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan
| | - Shiori Taura
- Department of Dental Anesthesiology, Graduate School of Dental Science, Kyushu University, Fukuoka, Japan
| | - Sayuri Kadowaki
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takashi Hitosugi
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoichiro Miki
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Takeshi Yokoyama
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Hu R, Niu JY, Wu LN, Sun H, Sun P, Huang JY, Yu JM. Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial. Trials 2021; 22:697. [PMID: 34645510 PMCID: PMC8513329 DOI: 10.1186/s13063-021-05677-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022] Open
Abstract
Background Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps. Methods Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision. Results All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) s vs Group T, 52.4 (3.1) s). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group. Conclusions We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI. Trial registration Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR190002 7387). This trial was prospectively registered on 11 November 2019.
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Affiliation(s)
- Rui Hu
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Jing-Yi Niu
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Li-Ning Wu
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Hao Sun
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Peng Sun
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Jia-Ying Huang
- Department of Otorhinolaryngology Surgery, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China
| | - Jun-Ma Yu
- Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Huaihe Road 390, Hefei, 230061, China.
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Gupta N, Gupta A, Sarma R, Batra A, Madan K. Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oro-maxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials. Korean J Anesthesiol 2021; 74:439-448. [PMID: 34365774 PMCID: PMC8497912 DOI: 10.4097/kja.21234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nasotracheal intubation (NTI) is commonly performed in oromaxillofacial surgeries. We did this meta-analysis to ascertain whether use of video laryngoscopy (VL) provided better NTI characteristics as compared to direct laryngoscopy (DL) in patients undergoing oromaxillofacial surgeries. Methods We performed a systematic search to identify randomized controlled trials comparing VL with DL for NTI in adults undergoing elective oromaxillofacial surgery. The primary outcome was time to intubation. Secondary outcomes included the first attempt success, overall success, incidence of nasal bleeding, Cormack and Lehane grade, and maneuvers required. Results Of the 456 studies identified following a systematic search, 10 were included. Meta-analysis showed a significantly lower time to tracheal intubation favoring VL (mean difference: –9.04, 95% CI [–12.71, –5.36], P < 0.001; I2 = 59%). VL was also associated with a greater first attempt success (relative risk [RR]: 1.10, 95% CI [1.04, 1.16], P = 0.001). Maneuvers to facilitate intubation were less with VL (RR: 0.22, 95% CI [0.10, 0.51], P < 0.001). There was no difference in overall intubation success (RR: 1.04, 95% CI [0.98, 1.10], P = 0.17). The incidence of bleeding did not differ between the DL and VL groups (RR: 0.59, 95% CI [0.32, 1.08], P = 0.09). Conclusions Evidence as per this meta-analysis suggests VL leads to a shorter time to NTI, a greater first attempt success rate, and reduced need for maneuvers when compared to DL. The present study supports use of VL as a first line device for NTI in oral-maxillofacial surgeries in experienced hands.
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Affiliation(s)
- Nishkarsh Gupta
- Department of Onco-Anaesthesia and Palliative Medicine, DR BRAIRCH, All India Institute of Medical Sciences, New Delhi
| | - Anju Gupta
- Department of Anaesthesia, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi
| | - Riniki Sarma
- Department of Onco-Anaesthesia and Palliative Medicine, DR BRAIRCH, All India Institute of Medical Sciences, New Delhi
| | - Atul Batra
- Department of Medical Oncology, DR BRAIRCH, All India Institute of Medical Sciences, New Delhi
| | - Karan Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi
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Zhu H, Liu J, Suo L, Zhou C, Sun Y, Jiang H. A randomized controlled comparison of non-channeled king vision, McGrath MAC video laryngoscope and Macintosh direct laryngoscope for nasotracheal intubation in patients with predicted difficult intubations. BMC Anesthesiol 2019; 19:166. [PMID: 31470814 PMCID: PMC6717380 DOI: 10.1186/s12871-019-0838-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND King Vision and McGrath MAC video laryngoscopes (VLs) are increasingly used. The purpose of this study was to evaluate the performance of nasotracheal intubation in patients with predicted difficult intubations using non-channeled King Vision VL, McGrath MAC VL or Macintosh laryngoscope by experienced intubators. METHODS Ninety nine ASA I or II adult patients, scheduled for oral maxillofacial surgeries with El-Ganzouri risk index 1-7 were enrolled. Patients were randomly allocated to intubate with one of three laryngoscopes (non-channeled King Vision, McGrath MAC and Macintosh). The intubators were experienced with more than 100 successful nasotracheal intubations using each device. The primary outcome was intubation time. The secondary outcomes included first success rate, time required for viewing the glottis, Cormack-Lehane grade of glottis view, the number of assist maneuvers, hemodynamic responses, the subjective evaluating of sensations of performances and associated complications. RESULTS The intubation time of King Vision and McGrath group was comparable (37.6 ± 7.3 s vs. 35.4 ± 8.8 s) and both were shorter than Macintosh group (46.8 ± 10.4 s, p < 0.001). Both King Vision and McGrath groups had a 100% first attempt success rate, significantly higher than Macintosh group (85%, p < 0.05). The laryngoscopy time was comparable between King Vision and McGrath group (16.7 ± 5.5 s vs. 15.6 ± 6.3 s) and was shorter than Macintosh group (22.8 ± 7.2 s, p < 0.05) also. Compared with Macintosh laryngoscope, Glottis view was obviously improved when exposed with either non-channeled King Vision or McGrath MAC VL (p < 0.001), and assist maneuvers required were reduced (p < 0.001). The maximum fluctuations of MAP were significantly attenuated in VL groups (47.7 ± 12.5 mmHg and 45.1 ± 10.3 mmHg vs. 54.9 ± 10.2 mmHg, p < 0.05 and p < 0.01). Most device insertions were graded as excellent in McGrath group, followed by Macintosh and King Vision group (p = 0.0014). The tube advancements were easier in VLs compared with the Macintosh laryngoscope (p < 0.001). Sore throat was found more frequent in Macintosh group compared with King Vision group (p < 0.05). CONCLUSIONS Non-channeled King Vision and McGrath MAC VLs were comparable and both devices facilitated nasotracheal intubation in managing predicted difficult intubations compared with Macintosh laryngoscope. TRIAL REGISTRATION ClinicalTrials registration number NCT03126344 . Registered on April 24, 2017.
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Affiliation(s)
- Haozhen Zhu
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jinxing Liu
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Lulu Suo
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Chi Zhou
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yu Sun
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Hong Jiang
- Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Shindo Y, Toda S, Kido K, Masaki E. Massive ameloblastoma: A case report of difficult fiberoptic intubation. Ann Med Surg (Lond) 2018; 32:6-9. [PMID: 30013771 PMCID: PMC6019686 DOI: 10.1016/j.amsu.2018.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/28/2018] [Accepted: 05/22/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Intubation can sometimes be difficult in patients with lesions in the mouth floor. Ameloblastoma is a frequently encountered tumor of the maxillofacial area. An extensive lesion might occupy the floor of the mouth, prevent displacement of the tongue, limiting the space for inserting a laryngoscope blade and resulting in difficult intubation even with fiberoptic bronchoscopy. CASE PRESENTATION A 66-year-old man (67 kg; 171 cm) with a mental swelling was diagnosed with ameloblastoma and scheduled for surgical resection. The tumor was extensive, occupying most of the anterior floor of the mouth. We were concerned about impossible direct laryngoscopy because the massive tumor in the floor of the mouth compressed the base of the tongue against the posterior wall of the pharynx, restricting the space for inserting the laryngoscope blade. Therefore, we planned to perform awake nasal fiberoptic intubation to secure the airway. Although the procedure was complicated by the massive tumor, successful intubation was achieved by hand-assisted alteration of the direction of the endotracheal tube (ETT) under direct laryngoscopy. DISCUSSION Awake fiberoptic intubation was complicated by the tumor protrusion to deviate the ETT. Discovering of the ETT deviation by the insufficient blade insertion facilitated visualizing the vocal cords with the fiberoptic scope. CONCLUSION Identification of ETT deviation even with insufficient blade insertion and hand-assisted alteration of the direction of the ETT might raise the chances of successful fiberoptic intubation. The anesthesiologist should be aware of the likelihood of failed fiberoptic intubation and plan for alternative approaches to secure the airway.
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Affiliation(s)
| | | | | | - Eiji Masaki
- Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, 4-1 Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
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Kim HJ, Park SI, Cho SY, Cho MJ. The GlideScope with modified Magill forceps facilitates nasogastric tube insertion in anesthetized patients: A randomized clinical study. J Int Med Res 2018; 46:3124-3130. [PMID: 29756483 PMCID: PMC6134664 DOI: 10.1177/0300060518772719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective Insertion of a nasogastric tube (NGT) in patients who have been intubated with an endotracheal tube while under general anesthesia can cause difficulties and lead to complications, including hemorrhage. A visualization-aided modality was recently used to facilitate NGT insertion. Some studies have focused on the role of modified Magill forceps, which have angles similar to those of the GlideScope blade (Verathon, Bothell, WA, USA). Methods Seventy patients were divided into a control group (Group C) and an experimental group (GlideScope and modified Magill forceps, Group M). Results The total NGT insertion time was significantly shorter in Group M than C (71.3 ± 22.6 vs. 96.7 ± 57.5 s; mean difference, –25.3 s; 95% confidence interval [CI], 20.8–71.5). There were also significantly fewer mean insertion attempts in Group M than C (1.0 ± 0.0 vs. 2.11 ± 0.93). The success rate for the first attempt in Group C was 37.1%, while that in Group M was 100% (relative risk, 2.7; 95% CI, 1.7–4.1). Conclusion The use of the GlideScope with modified Magill forceps for insertion of an NGT in patients who are already intubated and under general anesthesia will shorten the insertion time and improve the success rate.
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Affiliation(s)
- Han Joon Kim
- 1 Department of General Surgery, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea
| | - Su In Park
- 2 Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea
| | - Sang Yun Cho
- 2 Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea
| | - Min Jae Cho
- 2 Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea
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Abrons RO, Zimmerman MB, El-Hattab YMS. Nasotracheal intubation over a bougie vs. non-bougie intubation: a prospective randomised, controlled trial in older children and adults using videolaryngoscopy. Anaesthesia 2017; 72:1491-1500. [DOI: 10.1111/anae.14029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- R. O. Abrons
- Department of Anesthesiology; The University of Iowa Hospitals and Clinics; Iowa City Iowa USA
| | - M. B. Zimmerman
- Department of Biostatistics; The University of Iowa College of Public Health; Iowa City Iowa USA
| | - Y. M. S. El-Hattab
- Department of Anesthesiology; The University of Iowa Hospitals and Clinics; Iowa City Iowa USA
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11
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Tseng KY, Lu IC, Shen YC, Lin CH, Chen PN, Cheng KI. A comparison of the video laryngoscopes with Macintosh laryngoscope for nasotracheal intubation. Asian J Anesthesiol 2017; 55:17-21. [PMID: 28846537 DOI: 10.1016/j.aja.2017.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/01/2017] [Accepted: 02/16/2017] [Indexed: 10/19/2022]
Abstract
Nasotracheal intubation (NTI) is usually required in patients undergoing maxillofacial surgery. Though video-scopes have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning NTI. The aim of the study is to compare the efficiency of video-scopes and the traditional direct laryngoscopy in NTI. One hundred and eight patients scheduled for elective oro-maxillofacial surgery under nasotracheal intubation general anesthesia were randomly allocated into one of 3 groups of GlideScope, Pentax AirWay Scope, or Macintosh laryngoscope respectively. The primary outcome measures were total intubation time and each separate time interval (time A: for placement for the nasotracheal tube from selected nostril to oropharynx; time B: for use of devices to view the glottic opening; time C: for advancing nasotracheal tube from oropharynx into trachea and removing the scope from the oral cavity). The secondary outcomes were measurement of scores of modified naso-intubation difficulty scale (MNIDS) and attempts at intubation. RESULTS Mean total intubation time and time C interval were taken with GlideScope (33.1 s and 9.7 s), Pentax (38.4 s and 12.9 s), and Macintosh (42.2 s and 14.9 s) respectively. There was a significant difference among the groups (total time, P = 0.03; time C, P = 0.02). The median score of MNIDS was significantly lower using GlideScope or Pentax compared with using Macintosh in NTI (P = 0.037) and difficult intubation grading by MNIDS presented as easier in the GlideScope group than in the Macintosh group (0.016). Using GlideScope, intubation was successful at the first attempt in 80% patients whereas only 65% and 72.5% with the Pentax and Macintosh (P = 0.02). CONCLUSION As compared with the Macintosh laryngoscope, the GlideScope video laryngoscope facilitated nasotracheal intubations with shortened intubation time and reduced intubation difficulty in patients undergoing oromaxillofacial surgery.
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Affiliation(s)
- Kuang-Yi Tseng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - I-Cheng Lu
- Department of Anesthesiology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Chun Shen
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Heng Lin
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Po-Nien Chen
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Anesthesiology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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12
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Kleine-Brueggeney M, Buttenberg M, Greif R, Nabecker S, Theiler L. Evaluation of three unchannelled videolaryngoscopes and the Macintosh laryngoscope in patients with a simulated difficult airway: a randomised, controlled trial. Anaesthesia 2016; 72:370-378. [DOI: 10.1111/anae.13714] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/01/2022]
Affiliation(s)
- M. Kleine-Brueggeney
- Department of Peri-operative Medicine; Barts Heart Centre; Barts Health NHS Trust; London UK
- Department of Anaesthesiology and Pain Medicine; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - M. Buttenberg
- Department of Anaesthesiology and Pain Medicine; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - R. Greif
- Department of Anaesthesiology and Pain Medicine; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - S. Nabecker
- Department of Anaesthesiology and Pain Medicine; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - L. Theiler
- Department of Anaesthesiology and Pain Medicine; Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
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13
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Heuer JF, Heitmann S, Crozier TA, Bleckmann A, Quintel M, Russo SG. A comparison between the GlideScope® classic and GlideScope® direct video laryngoscopes and direct laryngoscopy for nasotracheal intubation. J Clin Anesth 2016; 33:330-6. [PMID: 27555188 DOI: 10.1016/j.jclinane.2016.04.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 04/16/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
DESIGN Prospective, randomized, clinical trial. SETTING University hospital operation room. PATIENTS 104 patients scheduled for elective dental or maxillofacial surgery were randomized to two groups: GlideScope® classic (GSc) and GlideScope® direct (GSd). INTERVENTIONS We compared the video laryngoscopes GSc and GSd with each other and with direct laryngoscopy (DL) for nasotracheal intubation with regard to visualization of the glottis, intubation success rate, and required time for and ease of intubation. The aim of the study was to determine whether the use of the video monitor alone reduced the difficulty of nasotracheal intubation, and also to investigate whether the GSc, with its blade designed for difficult airways, had an additional advantage over the video-assisted Macintosh blade (GSd). In both groups the investigators first performed laryngoscopy using the GSd blade, first with the monitor concealed and then with it visible. In the GSd group the tube was then inserted into the trachea with the video monitor screen visible. In the GSc group, the GSd blade was exchanged for the GSc blade, which was then used when inserting the tube with the screen visible. RESULTS The success rates and the times required for the video-assisted nasotracheal intubation did not differ significantly between the groups. A better view was obtained more often in the GSc group. In both groups there was a significant difference between direct laryngoscopy and the video-assisted intubation technique. Overall, using the video monitor improved the C-L scores by one grade in 52% and by two grades in 11% of the patients. CONCLUSIONS Video laryngoscopes increase the ease of nasotracheal intubation. The GSc blade might provide a better view of the laryngeal structures in case of a difficult airway than the GSd blade. Video laryngoscopy per se gives a better view of the glottis than direct laryngoscopy.
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Affiliation(s)
- Jan Florian Heuer
- Department of Anaesthesiology, Emergency- and Intensive Care Medicine, University of Goettingen Medical Center, Goettingen, Germany; Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Augusta-Kliniken Bochum Mitte, Bochum, Germany, University of Goettingen Medical Center, Goettingen, Germany.
| | - Sören Heitmann
- Department of Anaesthesiology, Emergency- and Intensive Care Medicine, University of Goettingen Medical Center, Goettingen, Germany.
| | - Thomas A Crozier
- Department of Anaesthesiology, Emergency- and Intensive Care Medicine, University of Goettingen Medical Center, Goettingen, Germany.
| | | | - Michael Quintel
- Department of Anaesthesiology, Emergency- and Intensive Care Medicine, University of Goettingen Medical Center, Goettingen, Germany.
| | - Sebastian G Russo
- Department of Anaesthesiology, Emergency- and Intensive Care Medicine, University of Goettingen Medical Center, Goettingen, Germany.
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14
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Gupta N, Garg R, Saini S, Kumar V. GlideScope video laryngoscope-assisted nasotracheal intubation by cuff-inflation technique in head and neck cancer patients. Br J Anaesth 2016; 116:559-60. [PMID: 26994237 DOI: 10.1093/bja/aew042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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15
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Lee MC, Tseng KY, Shen YC, Lin CH, Hsu CW, Hsu HJ, Lu IC, Cheng KI. Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway®. Anaesthesia 2015; 71:31-8. [DOI: 10.1111/anae.13232] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/26/2022]
Affiliation(s)
- M. C. Lee
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - K. Y. Tseng
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Y. C. Shen
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - C. H. Lin
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - C. W. Hsu
- Division of Oral Maxillofacial Surgery; Department of Dentistry; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - H. J. Hsu
- Division of Oral Maxillofacial Surgery; Department of Dentistry; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - I. C. Lu
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - K. I. Cheng
- Department of Anesthesiology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Anesthesiology; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
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16
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Szabó Z. New forceps for videolaryngoscopic intubation. Anaesthesia 2015; 70:1004-5. [DOI: 10.1111/anae.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Z. Szabó
- University Hospital; Linköping Sweden
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17
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Brück S, Trautner H, Wolff A, Hain J, Mols G, Pakos P, Roewer N, Lange M. Comparison of the C-MAC®and GlideScope®videolaryngoscopes in patients with cervical spine disorders and immobilisation. Anaesthesia 2014; 70:160-5. [DOI: 10.1111/anae.12858] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 11/30/2022]
Affiliation(s)
- S. Brück
- Department of Anaesthesia and Critical Care; University Hospital of Würzburg; Würzburg Germany
- Department of Cardioanaesthesia; University Hospital of Ulm; Ulm Germany
| | - H. Trautner
- Department of Anaesthesia and Critical Care; University Hospital of Würzburg; Würzburg Germany
| | - A. Wolff
- Department of Anaesthesia and Critical Care; University Hospital of Würzburg; Würzburg Germany
| | - J. Hain
- Department of Mathematics; University of Würzburg; Würzburg Germany
| | - G. Mols
- Department of Anaesthesia and Critical Care; Ortenau Klinikum Lahr-Ettenheim; Lahr Germany
| | - P. Pakos
- Department of Neurosurgery; University Hospital of Würzburg; Würzburg Germany
| | - N. Roewer
- Department of Anaesthesia and Critical Care; University Hospital of Würzburg; Würzburg Germany
| | - M. Lange
- Department of Anaesthesia and Critical Care; University Hospital of Würzburg; Würzburg Germany
- Department of Anaesthesia and Critical Care; Mathias-Spital-Rheine; Rheine Germany
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18
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Sims C. A suction catheter is a simple technique to aid nasal intubation with the GlideScope. Paediatr Anaesth 2013; 23:874. [PMID: 23927524 DOI: 10.1111/pan.12219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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