Purpose: A stylet is usually necessary when using the GlideScope(®) videolaryngoscope for orotracheal intubation. A special stylet, the GlideRite(®) Rigid Stylet (GRS), was designed for this purpose. A previous trial involving experienced operators showed that the GRS offered no performance improvement vs a standard malleable stylet (SMS). In our trial, we compared the performance of the GRS with that of the SMS in terms of time to intubation and ease of intubation when used by novice GlideScope(®) operators.
Methods: Sixty patients with normal-appearing airways requiring orotracheal intubation for elective surgery were randomly allocated to be intubated by novice operators with the GlideScope(®), using either the GRS or the SMS. Time to intubation was assessed by a blinded observer, and the operators were blinded until just prior to tracheal intubation. Ease of intubation was assessed by a five-point ordinal scale (from 1- easy to 5 -difficult). Intubation attempts/failures, glottic grades, and usage of external laryngeal manipulation were recorded.
Results: There were no significant differences between the GRS and the SMS in terms of the median time to intubation (60 sec, interquartile range [IQR] 48-75 vs 61 sec, IQR 49-75, respectively; P = 0.94) and the ease of intubation (GRS median score: 1.5, IQR 1-2 vs SMS median score: 1, IQR 1-2; P = 0.94). There were no other significant differences between groups.
Conclusion: The GRS and the SMS have similar performance characteristics when used by novice operators for GlideScope(®)-assisted orotracheal intubation. (Registered at ClinicalTrials.gov: NCT00884754).
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s12630-010-9440-z | DOI Listing |
J Neurosurg Anesthesiol
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Background: Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.
Methods: This retrospective study included unconscious patients who underwent orotracheal intubation using a flexible fiberscope while wearing a cervical collar to simulate a difficult airway.
Cureus
November 2024
Intensive Medicine, Hospital Pedro Hispano, Matosinhos, PRT.
Isolated cricoid fractures are exceedingly rare but can be life-threatening. Injuries caused by minor neck trauma related to external laryngeal manipulation or an inappropriate tube cuff size have been reported in the literature. Symptoms typically appear immediately after the traumatic episode.
View Article and Find Full Text PDFPatients with facial trauma are complex; difficult airway management is often anticipated and challenging for the anaesthetist. Awake tracheal intubation is the gold standard in the management of predicted difficult airway because of its high success rate and safety profile. We present the case of a patient with facial trauma who underwent orotracheal intubation with combined videolaryngoscopy and flexible bronchoscopy, under conscious sedation with intermittent boluses of ketamine and dexmedetomidine.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department Oral and Maxillofacial Surgery, University Hospital Zürich, 8032 Zürich, Switzerland.
Panfacial fractures are complex fractures involving multiple regions of the facial skeleton and may require multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including neurotrauma, which require either immediate (ATLS) airway management, prolonged intubation, or repeated intubations for staged surgeries. The choice of airway for the surgical management of these fractures is difficult, as an assessment of the occlusion is required, and the central nasal complex and/or skull base may be involved, making classical orotracheal or nasotracheal intubation problematic.
View Article and Find Full Text PDFBMJ
December 2024
Department of Anesthesia, Harvard Medical School, Boston, MA 02115, USA.
Objective: To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation.
Design: Randomized clinical trial.
Setting: Single center, quaternary children's hospital in Boston, MA, USA.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!