The performance of rigid scopes for tracheal intubation: a randomised,controlled trial in patients with a simulated difficult airway |
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Authors: | M. Kleine‐Brueggeney R. Greif N. Urwyler B. Wirthmüller L. Theiler |
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Affiliation: | 1. Department of Perioperative Medicine, Barts Heart Centre, Barts Health NHS Trust, London, UK;2. Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;3. Department of Internal Medicine, Spitalzentrum Oberwallis, Brig, Switzerland |
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Abstract: | We compared the Bonfils? and SensaScope? rigid fibreoptic scopes in 200 patients with a simulated difficult airway randomised to one of the two devices. A cervical collar inhibited neck movement and reduced mouth opening to a mean (SD) of 23 (3) mm. The primary outcome parameter was overall success of tracheal intubation; secondary outcomes included first‐attempt success, intubation times, difficulty of intubation, fibreoptic view and side‐effects. The mean (95% CI) overall success rate was 88 (80–94)% for the Bonfils and 89 (81–94)% for the SensaScope (p = 0.83). First‐attempt intubation success rates were 63 (53–72)% for the Bonfils and 72 (62–81)% for the SensaScope (p = 0.17). Median (IQR [range]) intubation time was significantly shorter with the SensaScope (34 (20–84 [5–240]) s vs. 45 (25–134 [12–230]) s), and fibreoptic view was significantly better with the SensaScope (full view of the glottis in 79% with the SensaScope vs. 61% with the Bonfils). This might be explained by its steerable tip and the S‐formed shape, contributing to better manoeuvrability. There were no differences in the difficulty of intubation or side‐effects. |
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Keywords: | cervical fracture: intubation techniques difficult airway algorithm failed intubation: treatment rigid fibreoptic scopes simulated difficult airway |
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