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Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jan 2023To study the application value of humidified high flow nasal cannula (HHFNC) combined with visual laryngoscopy in the arytenoid cartilage dislocation. Twenty-nine... (Randomized Controlled Trial)
Randomized Controlled Trial
To study the application value of humidified high flow nasal cannula (HHFNC) combined with visual laryngoscopy in the arytenoid cartilage dislocation. Twenty-nine patients with arytenoid cartilage dislocation were randomly double-blind into HHFNC group and general nasal catheter oxygen suction group, and the intraoperative and postoperative evaluation indicators, anesthesia-related indicators and postoperative vocal cord were compared. There were statistically significant differences in intraoperative blood oxygen saturation, microstream end-tidal carbon dioxide partial pressure EtCO₂, respiratory rate and respiratory intervention times between the two groups (<0.05), and statistically significant differences in postoperative heart rate, oxygen saturation and respiratory rate (<0.05). After reduction, the voice disturbance index, the degree of voice abnormality, rough voice, breath sound, powerless pronunciation and catatonic pronunciation changed significantly after operation. HHFNC combined with visual laryngoscopy in the arytenoid cartilage dislocation has high anesthetic safety, good cooperation of patients, and good surgical effect.
Topics: Humans; Cannula; Laryngoscopes; Laryngoscopy; Catheterization; Voice Disorders; Arytenoid Cartilage
PubMed: 36597372
DOI: 10.13201/j.issn.2096-7993.2023.01.013 -
Medicina (Kaunas, Lithuania) Jan 2023: Difficult intubation, which may be encountered unexpectedly during anesthesia, can increase patients' morbidity and mortality. The McGRATH video laryngoscope is known... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of the McGRATH Video Laryngoscope and Macintosh Laryngoscope for Orotracheal Intubation in a Simulated Difficult Airway Scenario: An Open-Label, Randomized Clinical Trial.
: Difficult intubation, which may be encountered unexpectedly during anesthesia, can increase patients' morbidity and mortality. The McGRATH video laryngoscope is known to provide improved laryngeal visibility in patients with difficult or normal airways. The purpose of this study was to evaluate the efficacy of the McGRATH video laryngoscope for orotracheal intubation compared with that of conventional Macintosh laryngoscopes in simulated difficult airway scenarios. : In this randomized controlled trial, patients who were scheduled for surgery under general anesthesia requiring orotracheal intubation were assigned to the Macintosh laryngoscope (n = 50) or McGRATH video laryngoscope (n = 45) groups. In this study, to create a simulated difficult airway condition, the subjects performed manual in-line stabilization and applied a soft cervical collar. The primary outcome was the rate of successful intubation within 30 s. The time required for an intubation, glottis grade, intubation difficulty scale (IDS score), the subjective ease of intubation, and optimal external laryngeal manipulation (OLEM) were evaluated. In addition, complications caused by each blade were investigated. : The intubation success rate within 30 s was not significantly different between the two groups (44 (88.0%) vs. 36 (80.0%), = 0.286). The glottic grade was better in the McGRATH group than in the Macintosh group ( = 0.029), but neither the intubation time (26.3 ± 8.2 s vs. 24.2 ± 5.0 s, = 0.134) nor the rates of oral bleeding (2 (4.0%) vs. 0 (0.0%)) and tooth injury (0 (0.0%) vs. 1 (2.2%)) were significantly different between the two groups. : The use of the McGRATH video laryngoscope did not improve the intubation success rate or shorten the intubation time. However, the McGRATH video laryngoscope provided a better glottis view than the conventional Macintosh laryngoscope in patients with a simulated difficult airway.
Topics: Humans; Laryngoscopes; Laryngoscopy; Intubation, Intratracheal; Anesthesia, General
PubMed: 36837484
DOI: 10.3390/medicina59020282 -
Journal of the Chinese Medical... Aug 2017This study aimed to investigate video-guided laryngoscopy for nasogastric tube placement.
BACKGROUND
This study aimed to investigate video-guided laryngoscopy for nasogastric tube placement.
METHODS
This was an observational comparative study performed in a hospital. The participants included volunteers from the medical staff (physicians and nurses) experienced with nasogastric intubation, and non-medical staff (medical students, pharmacists and emergent medical technicians) with knowledge of nasogastric intubation but lacking procedural experience. Medical and non-medical hospital staff performed manual, laryngoscope-assisted and video-guided laryngoscope nasogastric intubation both in the presence and in the absence of an endotracheal tube, using a manikin. Nasogastric intubation times were compared between groups and methods.
RESULTS
Using the video-guided laryngoscope resulted in a significantly shorter intubation time compared to the other 2 methods, both with and without an endotracheal tube, for the medical and non-medical staff alike (all p < 0.05). For the medical staff, mean nasogastric intubation time was significantly shorter using video-guided laryngoscope without endotracheal intubation, direct laryngoscope with endotracheal intubation and video-guided laryngoscope with endotracheal intubation compared to manual intubation without endotracheal intubation (0.49, 0.63 and 0.72 vs. 5.63, respectively, p ≤ 0.008). For non-medical staff, nasogastric intubation time was significantly shorter using video-guided laryngoscope without endotracheal intubation, direct laryngoscope with endotracheal intubation and video-guided laryngoscope with endotracheal intubation compared to manual intubation without endotracheal intubation (1.67, 1.58 and 0.95 vs. 6.9, respectively, p ≤ 0.002). And mean nasogastric intubation time for video-guided laryngoscope endotracheal intubation was significantly shorter for medical staff than for non-medical staff (0.49 vs. 1.67 min, respectively, p = 0.041).
CONCLUSION
Video-guided laryngoscope reduces nasogastric intubation time compared to manual and direct laryngoscope intubation, which promotes a consistent technique when performed by experienced medical and previously untrained non-medical staff.
Topics: Humans; Intubation, Gastrointestinal; Laryngoscopes; Manikins; Time Factors; Video-Assisted Surgery
PubMed: 28601629
DOI: 10.1016/j.jcma.2017.01.009 -
Brazilian Journal of Anesthesiology... 2021
Topics: Equipment Design; Humans; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Retirement
PubMed: 33894868
DOI: 10.1016/j.bjane.2020.11.008 -
BMC Anesthesiology Dec 2017McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to... (Comparative Study)
Comparative Study Randomized Controlled Trial
The usefulness of the McGrath MAC laryngoscope in comparison with Airwayscope and Macintosh laryngoscope during routine nasotracheal intubation: a randomaized controlled trial.
BACKGROUND
McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to determine the usefulness of McGrath MAC for routine nasotracheal intubation by comparing McGrath MAC with Airway scope and Macintosh laryngoscope.
METHODS
A total of 60 adult patients with ASA physical status class 1 or 2, aged 20-70 years were enrolled in this study. Patients were scheduled for elective oral surgery under general anesthesia with nasotracheal intubation. Exclusion criteria included lack of consent and expected difficult airway. Patients were randomly allocated to three groups: McGrath MAC (n = 20), Airway scope (n = 20), and Macintosh laryngoscope (n = 20). After induction, nasotracheal intubation was performed by six expert anesthesiologists with more than 6 years of experience.
RESULTS
There were no significant differences in preoperative airway assessment among the three groups. Successful tracheal intubation time was 26.8 ± 5.7 (mean ± standard deviation) s for McGrath MAC, 36.4 ± 11.0 s for Airway scope, and 36.5 ± 8.9 s for Macintosh laryngoscope groups. The time for successful tracheal intubation for McGrath MAC group was significantly shorter than that for Airway scope and Macintosh laryngoscope (p < 0.01). McGrath MAC significantly improved the Cormack Lehane grade for nasotracheal intubation compared with Macintosh laryngoscope (p < 0.05).
CONCLUSION
McGrath MAC significantly facilitates routine nasotracheal intubation compared with Airwayscope and Macintosh laryngoscope by shortening the tracheal intubation time and improving the Cormack Lehane grade.
TRIAL REGISTRATION
UMINCTR Registration number UMIN000023506 . Registered 5 Aug 2016.
Topics: Adult; Aged; Anesthesia, General; Equipment Design; Female; Humans; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Male; Middle Aged
PubMed: 29191160
DOI: 10.1186/s12871-017-0451-y -
BMC Emergency Medicine Jan 2021Failed airway management is the major contributor for anaesthesia-related morbidity and mortality. Cannot-intubate-cannot-ventilate scenarios are the most critical...
BACKGROUND
Failed airway management is the major contributor for anaesthesia-related morbidity and mortality. Cannot-intubate-cannot-ventilate scenarios are the most critical emergency in airway management, and belong to the worst imaginable scenarios in an anaesthetist's life. In such situations, apnoeic oxygenation might be useful to avoid hypoxaemia. Anaesthesia guidelines recommend careful preoxygenation and application of high flow oxygen in difficult intubation scenarios to prevent episodes of deoxygenation. In this study, we evaluated the decrease in oxygen concentration in a model when using different strategies of oxygenation: using a special oxygenation laryngoscope, nasal oxygen, nasal high flow oxygen, and control.
METHODS
In this experimental study we compared no oxygen application as a control, standard pure oxygen application of 10 l·min via nasal cannula, high flow 90% oxygen application at 20 l·min using a special nasal high flow device, and pure oxygen application via our oxygenation laryngoscope at 10 l·min. We preoxygenated a simulation lung to 97% oxygen concentration and connected this to the trachea of a manikin model simulating apnoeic oxygenation. Decrease in oxygen concentration in the simulation lung was measured continuously for 20 min.
RESULTS
Oxygen concentration in the simulation lung dropped from 97 ± 1% at baseline to 40 ± 1% in the no oxygen group, to 80 ± 1% in the standard nasal oxygen group, and to 73 ± 2% in the high flow nasal oxygenation group. However, it remained at 96 ± 0% in the oxygenation laryngoscope group (p < 0.001 between all groups).
CONCLUSIONS
In this technical simulation, oxygenation via oxygenation laryngoscope was more effective than standard oxygen insufflation via nasal cannula, which was more effective than nasal high flow insufflation of 90% oxygen.
Topics: Airway Management; Cannula; Humans; Laryngoscopes; Lung; Oxygen Inhalation Therapy; Respiration, Artificial
PubMed: 33482735
DOI: 10.1186/s12873-021-00407-5 -
BioMed Research International 2015Early airway management is very important for severely ill patients. This study aimed to investigate the efficacy of face to face intubation in four different types of...
A Randomized Comparison Simulating Face to Face Endotracheal Intubation of Pentax Airway Scope, C-MAC Video Laryngoscope, Glidescope Video Laryngoscope, and Macintosh Laryngoscope.
OBJECTIVES
Early airway management is very important for severely ill patients. This study aimed to investigate the efficacy of face to face intubation in four different types of laryngoscopes (Macintosh laryngoscope, Pentax airway scope (AWS), Glidescope video laryngoscope (GVL), and C-MAC video laryngoscope (C-MAC)).
METHOD
Ninety-five nurses and emergency medical technicians were trained to use the AWS, C-MAC, GVL and Macintosh laryngoscope with standard airway trainer manikin and face to face intubation. We compared VCET (vocal cord exposure time), tube pass time, 1st ventilation time, VCET to tube pass time, tube pass time to 1st ventilation time, and POGO (percentage of glottis opening) score. In addition, we compared success rate according to the number of attempts and complications.
RESULT
VCET was similar among all laryngoscopes and POGO score was higher in AWS. AWS and Macintosh blade were faster than GVL and C-MAC in total intubation time. Face to face intubation success rate was lower in GVL than other laryngoscopes.
CONCLUSION
AWS and Macintosh were favorable laryngoscopes in face to face intubation. GVL had disadvantage performing face to face intubation.
Topics: Adult; Clinical Competence; Female; Health Personnel; Humans; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Male; Manikins; Middle Aged; Vocal Cords
PubMed: 26161424
DOI: 10.1155/2015/961782 -
Annals of Cardiac Anaesthesia 2019Hemodynamic responses during laryngoscopy can potentially precipitate ischemia in patients with coronary artery disease. There are conflicting reports regarding the... (Comparative Study)
Comparative Study Randomized Controlled Trial
Comparative evaluation of hemodynamic responses and ease of intubation with airtraq video laryngoscope versus macintosh laryngoscope in patients with ischemic heart disease.
INTRODUCTION
Hemodynamic responses during laryngoscopy can potentially precipitate ischemia in patients with coronary artery disease. There are conflicting reports regarding the hemodynamic stress responses between the conventional Macintosh and video laryngoscopes. There is a paucity of studies regarding the same in cardiac surgical patients.
MATERIALS AND METHODS
A prospective, randomized control study to compare the hemodynamic responses and ease of intubation using Airtraq video laryngoscope and Macintosh laryngoscope in patients with ischemic heart disease.
RESULTS
Seventy patients were randomized into two groups. Baseline variables including age, weight, Mallampati score, and comorbidities were comparable between the two groups. There was statistically significant elevation in mean heart rate in the Macintosh group at 2-min (P = 0.02) and 3-min (P = 0.05) postintubation. Similarly, there was a significant increase in mean arterial pressure at 2 (P = 0.06), 3 (P = 0.03), and 4 (P = 0.03) in the Macintosh group. The time for laryngoscopy and Intubation Difficulty Scale was significantly better in the Airtraq group (P = 0.001 and 0.001). However, the median time to intubation was longer in the Airtraq group (13 s vs. 11 s, P = 0.05). Laryngoscopy view was better with Airtraq even in patients with Mallampati score 3 (ten patients). The incidence of trauma was same in both the groups.
CONCLUSION
Airtraq provides the better hemodynamic stability and ease of intubation and may be considered superior to conventional Macintosh laryngoscope for intubation in patients with ischemic heart disease.
Topics: Adult; Age Factors; Aged; Arterial Pressure; Body Weight; Coronary Artery Bypass; Equipment Design; Female; Heart Rate; Hemodynamics; Humans; Incidence; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Male; Middle Aged; Myocardial Ischemia; Postoperative Complications; Prospective Studies; Trachea
PubMed: 31621670
DOI: 10.4103/aca.ACA_120_18 -
Korean Journal of Anesthesiology Aug 2022Video laryngoscopes are approved equipment for difficult airway intubations. The borescope, which was introduced during the coronavirus disease 2019 (COVID-19) era, is... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Video laryngoscopes are approved equipment for difficult airway intubations. The borescope, which was introduced during the coronavirus disease 2019 (COVID-19) era, is placed over a direct laryngoscope blade to provide an economical video laryngoscope. In the current study, we investigated the use of an endotracheal tube mounted over a USB borescope versus a video laryngoscope in patients with suspected difficult airways.
METHODS
After obtaining informed consent, 120 adult patients with suspected difficult airways undergoing elective surgery were included in this study. Patients were randomized into the USB borescope and video laryngoscope groups. The primary outcome was time to successful intubation. The secondary outcomes included hemodynamic changes, anesthetist's satisfaction, and the incidence of complications.
RESULTS
Intubation time was comparable between the two groups (video laryngoscope: 30.63 s and borescope: 28.35 s; P = 0.166). However, the view was clearer (P = 0.026) and the incidence of fogging was lower (P = 0.015) with the video laryngoscope compared to the borescope. Conversely, anesthetist's satisfaction frequency was higher with the borescope than with the video laryngoscope (P < 0.001).
CONCLUSIONS
The video laryngoscope provided a better view and less fogging with an intubation time that was comparable to that of the borescope; however, the higher cost of the video laryngoscope limits its availability. Therefore, the borescope is a low-cost, readily available device that can be used for intubating patients with potentially difficult airways.
Topics: Adult; COVID-19; Humans; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Prospective Studies
PubMed: 35581709
DOI: 10.4097/kja.22222 -
Brazilian Journal of Anesthesiology... 2017Laryngoscope is a key tool in anesthetic practice. Direct laryngoscopy is a crucial moment and inadequate laryngoscope's light can lead to catastrophic consequences.... (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVES
Laryngoscope is a key tool in anesthetic practice. Direct laryngoscopy is a crucial moment and inadequate laryngoscope's light can lead to catastrophic consequences. From our experience laryngoscope's light is assessed in a subjective manner and we believe a more precise evaluation should be used. Our objective is to compare the accuracy of a smartphone compared to a lux meter. Secondly we audited our Operating Room laryngoscopes.
METHODS
We designed a pragmatic study, using as primary outcome the accuracy of a smartphone compared to the lux meter. Further we audited with both the lux meter and the smartphone all laryngoscopes and blades ready to use in our Operating Rooms, using the International Standard form the International Organization for Standardization.
RESULTS
For primary outcome we found no significant difference between devices. Our audit showed that only 2 in 48 laryngoscopes complied with the ISO norm. When comparing the measurements between the lux meter and the smartphone we found no significant difference.
DISCUSSION
Ideally every laryngoscope should perform as required. We believe all laryngoscopes should have a practical but reliable and objective test prior to its utilization. Our results suggest the smartphone was accurate enough to be used as a lux meter to test laryngoscope's light. Audit results showing only 4% comply with the ISO standard are consistent with other studies.
CONCLUSION
The tested smartphone has enough accuracy to perform light measurement in laryngoscopes. We believe this is a step further to perform an objective routine check to laryngoscope's light.
Topics: Equipment Design; Humans; International Agencies; Laryngoscopes; Laryngoscopy; Light; Operating Rooms; Smartphone
PubMed: 28236866
DOI: 10.1016/j.bjane.2016.07.007