Pre-formed endotracheal tube and stepwise insertion for more successful intubation with video laryngoscopy  

作　　者：Ahmed A Shorrab Moustafa A Helal 

机构地区：[1]Department of Anesthesia,University Hospital Sharjah,Sharjah POB 72772,United Arab Emirates [2]Faculty of Medicine,Mansoura University,Mansoura 35516,Egypt [3]University Hospital Sharjah,Sharjah,United Arab Emirates

出　　处：《World Journal of Anesthesiology》2021年第2期7-15,共9页世界麻醉学杂志

基　　金：the Ethics and Research Committee of University Hospital Sharjah,No.UHS-HERC-014-30072019.

摘　　要：BACKGROUND In anesthesia practice,orotracheal intubation remains the primary concern of the anesthesiologist.The introduction of video laryngoscopy(VL)has increased the success rate of orotracheal intubation;however,conflicting results have been reported regarding the usefulness of the current technique with VL in clinical practice.AIM To describe a modification to improve intubation with VL,followed by evaluation of the practice in vivo.METHODS First,a mannequin trial was conducted with operators having different experience and background.Then,a retrospective analysis was performed for an>1-year period with patients who underwent general anesthesia with orotracheal intubation.The endotracheal tube used had been pre-formed with two curves.Stepwise intubation had been performed with direct eye vision,followed by screen assistance and rotation of the tube as needed to direct it toward the glottis.In the mannequin trial,the outcome measures were quantification of torque(force with angular acceleration during levering),need for external maneuvers,and time to intubate.In the clinical experience,orotracheal intubation used VL(pre-formed tube)or direct laryngoscopy(DL)at the anesthetist’s discretion and throat discomfort was reported by the patient.RESULTS In the mannequin trials using VL,there was less torque with the pre-formed tube than with a regular tube(8%and 65%,respectively).The first-pass rate was higher with the pre-formed tube(95%)than with a regular tube(81%).However,the time to intubate was longer with the pre-formed tube than with a regular tube(22 s and 12 s,respectively).In clinical practice,562 patients underwent surgery under general anesthesia with orotracheal intubation using either VL(n=244)or DL(n=318)at the discretion of the attending anesthetist.VL was specifically planned in 62 of the patients,due to anticipated difficulty.Second attempts by readjustment of the curve of the tube were significantly fewer with VL than with DL(10%vs 18%).Throat discomfort was reported by fewer patients who underw

关 键 词：INTUBATION Glottis view AIRWAY Indirect laryngoscopy Torque 

分 类 号：R76[医药卫生—耳鼻咽喉科]