1
|
Kocaturk O, Keles S. Comparison of the HugeMed video laryngoscope with the Macintosh direct laryngoscope for nasotracheal tracheal intubation in children undergoing dental treatment: a randomized controlled clinical study. Expert Rev Med Devices 2024:1-8. [PMID: 38829609 DOI: 10.1080/17434440.2024.2363289] [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: 01/25/2024] [Accepted: 04/26/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES The aim of this study was to compare the performance of the HugeMed® videolaryngoscope with a direct Macintosh laryngoscope for nasotracheal intubation. METHODS Eighty-eight children aged 4-10 years were randomly assigned to either the HugeMed® videolaryngoscope (HVL) or the Macintosh direct laryngoscope (MDL) group. Intubation difficulty, glottic view grade, time-to-intubation, number of tracheal intubation attempts, use of external laryngeal manipulation and Magill forceps, recovery time, pediatric-anesthesia-delirium-scale (PAEDS) scores, pain due to tracheal intubation, and laryngeal bleeding were evaluated. RESULTS Easy tracheal intubation incidence was higher in the HVL group than that in the MDL group (p = 0.001). Glottic view was better in the HVL group as compared to the MDL group (p = 0.027). There was no difference between the groups in terms of time-to-tracheal intubation, number of tracheal intubation attempts, Magill forceps usage, pain, and bleeding due to tracheal intubation. The need for external laryngeal manipulation (p = 0.004) and PAEDS scores (p = 0.006) were higher in the MDL group than those in the HVL group. CONCLUSION HugeMed® videolaryngoscope may provide easier tracheal intubation, create a better glottic view, and significantly reduce the need for additional manipulation compared to the Macintosh direct laryngoscope, for nasotracheal intubation. CLINICAL TRIAL REGISTRATION www.clinicaltrial.gov identifier is NCT05121597.
Collapse
Affiliation(s)
- Ozlem Kocaturk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Division of Anesthesiology, Aydin Adnan Menderes University, Aydın, Turkey
| | - Sultan Keles
- Department of Pediatric Dentistry, Faculty of Dentistry, Aydin Adnan Menderes University, Aydin, Turkey
| |
Collapse
|
2
|
Cafferkey J, Ward PA. Intubation aids in hyperangulated videolaryngoscopy: essential components more than just adjuncts. Anaesthesia 2024; 79:659-660. [PMID: 38306489 DOI: 10.1111/anae.16244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Affiliation(s)
| | - P A Ward
- St John's Hospital, Livingston, UK
| |
Collapse
|
3
|
McNarry AF, Ward P, Silas U, Saunders R, Saunders SJ. Macintosh-style videolaryngoscope use for tracheal intubation in elective surgical patients revisited: a sub-analysis of the 2022 Cochrane review data. Patient Saf Surg 2024; 18:20. [PMID: 38807147 PMCID: PMC11134739 DOI: 10.1186/s13037-024-00402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 05/18/2024] [Indexed: 05/30/2024] Open
Abstract
The Cochrane systematic review and meta-analysis published in 2022 that compared videolaryngoscopy (VL) with direct laryngoscopy (DL) for facilitating tracheal intubation in adults found that all three types of VL device (Macintosh-style, hyper-angulated and channeled) reduced the risk of failed intubation and increased the likelihood of first-pass success. We report the findings of a subgroup re-analysis of the 2022 Cochrane meta-analysis data focusing on the Macintosh-style VL group. This was undertaken to establish whether sufficient evidence exists to guide airway managers in making purchasing decisions for their local institutions based upon individual device-specific performance. This re-analysis confirmed the superiority of Macintosh-style VL over Macintosh DL in elective surgical patients, with similar efficacy demonstrated between the Macintosh-style VL devices examined. Thus, when selecting which VL device(s) to purchase for their hospital, airway managers decisions are likely to remain focused upon issues such as financial costs, portability, cleaning schedules and previous device experience.
Collapse
Affiliation(s)
- Alistair F McNarry
- Department of Anaesthesia, St John's Hospital, NHS Lothian, Edinburgh, UK.
| | - Patrick Ward
- Department of Anaesthesia, St John's Hospital, NHS Lothian, Edinburgh, UK
| | | | | | | |
Collapse
|
4
|
Ward PA, McNarry AF. Maximising the benefit of new technologies in airway management. Indian J Anaesth 2024; 68:412-414. [PMID: 38764956 PMCID: PMC11100643 DOI: 10.4103/ija.ija_337_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/21/2024] Open
Affiliation(s)
- Patrick A. Ward
- Consultant Anaesthetist NHS Lothian, Department of Anaesthesia St John's Hospital, Howden, Livingston, United Kingdom
| | - Alistair F. McNarry
- Consultant Anaesthetist NHS Lothian, Department of Anaesthesia St John's Hospital, Howden, Livingston, United Kingdom
- Department of Anaesthesia, Western General Hospital, Crewe Road South, Edinburgh, United Kingdom
| |
Collapse
|
5
|
Kim JH, Cheon BR, Kim H, Hwang SM, Lee JJ, Kwon YS. Influence of Curved Video Laryngoscope Blade Sizes and Patient Heights on Video Laryngoscopic Views: A Randomized Controlled Trial. J Pers Med 2024; 14:209. [PMID: 38392642 PMCID: PMC10889943 DOI: 10.3390/jpm14020209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to compare the video laryngoscope views facilitated by curved blades 3 and 4 with an exploration of the relationship between these views and patient height. Conducted as a randomized controlled trial, this study enrolled adults scheduled for surgery under general anesthesia. Intubation procedures were recorded, and the percentage of glottic opening was measured before tube insertion. Multivariate analysis validated the impact of various factors, including blade size and patient height, on the percentage of glottic opening scores. A total of 192 patients were included. The median percentage of glottic opening scores for curved blades 3 and 4 were 100 and 83, respectively (p < 0.001). The unstandardized coefficient indicated a significant negative impact of blade 4 on the percentage of glottic opening scores (-13, p < 0.001). In the locally estimated scatterplot smoothing analysis, blade 3 exhibited a steady rise in glottic opening scores with increasing height, whereas blade 4 showed a peak followed by a decline around 185 cm. The unstandardized coefficient of height showed no significant association (0, p = 0.819). The study observed superior laryngoscopic views with blade 3 compared to blade 4. However, no significant association was found between laryngoscopic views and patient height.
Collapse
Affiliation(s)
- Jong-Ho Kim
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
- Institute of New Frontier Research, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| | - Bo-Reum Cheon
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| | - Hyesook Kim
- Institute of New Frontier Research, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| | - Sung-Mi Hwang
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| | - Jae-Jun Lee
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
- Institute of New Frontier Research, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| | - Young-Suk Kwon
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
- Institute of New Frontier Research, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea
| |
Collapse
|
6
|
Messina S, Merola F, Santonocito C, Sanfilippo M, Sanfilippo G, Lombardo F, Bruni A, Garofalo E, Murabito P, Sanfilippo F. Articulating Video Stylet Compared to Other Techniques for Endotracheal Intubation in Normal Airways: A Simulation Study in Consultants with No Prior Experience. J Clin Med 2024; 13:728. [PMID: 38337422 PMCID: PMC10856441 DOI: 10.3390/jcm13030728] [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: 12/18/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Simulation for airway management allows for acquaintance with new devices and techniques. Endotracheal intubation (ETI), most commonly performed with direct laryngoscopy (DL) or video laryngoscopy (VLS), can be achieved also with combined laryngo-bronchoscopy intubation (CLBI). Finally, an articulating video stylet (ProVu) has been recently introduced. A single-center observational cross-sectional study was performed in a normal simulated airway scenario comparing DL, VLS-Glidescope, VLS-McGrath, CLBI and ProVu regarding the success rate (SR) and corrected time-to-intubation (cTTI, which accounts for the SR). Up to three attempts/device were allowed (maximum of 60 s each). Forty-two consultants with no experience with ProVu participated (15 ± 9 years after training completion). The DL was significantly faster (cTTI) than all other devices (p = 0.033 vs. VLSs, and p < 0.001 for CLBI and Provu), no differences were seen between the two VLSs (p = 0.775), and the VLSs were faster than CLBI and ProVu. Provu had a faster cTTI than CLBI (p = 0.004). The DL and VLSs showed similar SRs, and all the laryngoscopes had a higher SR than CLBI and ProVu at the first attempt. However, by the third attempt, the SR was not different between the DL/VLSs and ProVu (p = 0.241/p = 0.616); ProVu was superior to CLBI (p = 0.038). In consultants with no prior experience, ProVu shows encouraging results compared to DL/VLSs under simulated normal airway circumstances and further studies are warranted.
Collapse
Affiliation(s)
- Simone Messina
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Federica Merola
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
| | - Cristina Santonocito
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
| | - Marco Sanfilippo
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Giulia Sanfilippo
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Federica Lombardo
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Andrea Bruni
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Eugenio Garofalo
- School of Anesthesia and Intensive Care, University “Magna Graecia”, 88100 Catanzaro, Italy; (M.S.); (G.S.); (A.B.); (E.G.)
| | - Paolo Murabito
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
| | - Filippo Sanfilippo
- Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy; (S.M.); (F.M.); (C.S.); (F.L.); (P.M.)
- Section of Anesthesia, Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95124 Catania, Italy
| |
Collapse
|
7
|
Petkar S, Chakole V, Nayak A. Comprehensive Review of Anesthetic Evaluation and Management in Obese Female Patients Undergoing In Vitro Fertilization. Cureus 2023; 15:e47521. [PMID: 38021482 PMCID: PMC10664690 DOI: 10.7759/cureus.47521] [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: 09/19/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Obesity has become a global health epidemic with profound implications for various medical specialties, including reproductive medicine. This comprehensive review focuses on the anesthetic evaluation and management of obese patients undergoing in vitro fertilization (IVF) procedures. Obesity, as defined by BMI, is associated with infertility and poses unique challenges for anesthetic care. The review also addresses the timing of anesthesia concerning IVF procedures, the impact of obesity on IVF success rates, and the importance of emotional and psychological support for obese patients undergoing IVF. Challenges and future directions in the field are highlighted, focusing on ongoing research, emerging technologies, and the role of multidisciplinary teams in managing these complex cases. In conclusion, this review underscores the critical role of tailored anesthesia and perioperative care in optimizing outcomes for obese patients undergoing IVF. It provides valuable insights for anesthetic providers, reproductive specialists, and healthcare teams, emphasizing the need for a patient-centered approach to address the unique challenges posed by obesity in the context of assisted reproductive technology.
Collapse
Affiliation(s)
- Shubham Petkar
- Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vivek Chakole
- Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aishwarya Nayak
- Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|