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The performance of rigid scopes for tracheal intubation: a randomised,controlled trial in patients with a simulated difficult airway
Authors:M. Kleine‐Brueggeney  R. Greif  N. Urwyler  B. Wirthmüller  L. Theiler
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
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.
Keywords:cervical fracture: intubation techniques  difficult airway algorithm  failed intubation: treatment  rigid fibreoptic scopes  simulated difficult airway
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