A Randomized Controlled Trial Comparing the Utility of Lighted Stylet and GlideScope for Double-Lumen Endobronchial Intubation

Chang, Jong San; Kim, Hye Rim; Min, Sang Il; Lee, Jung Man; Ryu, Jung Hee; Yoon, Se Chang; Hwang, Jin Young

doi:10.1053/j.jvca.2017.10.009

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…In the author' study, the effectiveness of the first attempt of intubation with a double-lumen tube was 90% and the total effectiveness of intubation was 100%. The results are similar to other studies where videolaryngoscopes where used to facilitate endotracheal intubation [20,21]. Bakshi et al compared the time to intubation for double-lumen tube insertion using the McGrath® MAC VL versus direct Macintosh laryngoscope and revealed that this parameter was similar on both groups, however videolaryngoscopy was associated with better glottis visualization, reduced need of external laryngeal manipulation and fewer complications [22].…”

Section: Discussionsupporting

confidence: 81%

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Karczewska

Smereka

Szarpak

et al. 2020

Disaster Emerg Med J

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INTRODUCTION: The airway management and the implementation of optimal oxygen therapy in trauma patients, especially unconscious ones, is a key element of prehospital management. However, in cases of trauma lung or bronchial rupture, both lungs ventilation may not be advisable. In such cases, intubation with a double-lumen endotracheal tube may be helpful, allowing to provide one-lung ventilation. The aim of the experimental study was to assess the impact of short training in intubation using double-lumen tubes on the effectiveness of intubation performance and one-lung ventilation by paramedics in a simulated trauma patient setting. MATERIAL AND METHODS: This was a prospective, observational, randomized experimental trial. The study involved 30 paramedics. The participants had to perform tracheal intubation using Double Lumen Tube VivaSight-DL (VS-DL; ETView Ltd.; Misgav, Israel) under normal airway conditions. The effectiveness of the first intubation attempt, the time of intubation and the Cormack-Lehane scale were evaluated. RESULTS: The effectiveness of the first attempt at intubation with a double-lumen tube was 90% and the total effectiveness of intubation was 100%. The median time of the procedure was 63 (IQR; 38-72.5) seconds. CONCLUSIONS: In the simulation study, the paramedics were able to intubate using a double tube after a short training.

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Section: Discussionsupporting

confidence: 81%

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Karczewska

Smereka

Szarpak

et al. 2020

Disaster Emerg Med J

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“…Tracheal intubation was confirmed by square waves on capnography. The intracuff pressure was monitored every 30 min using a handheld aneroid manometer (VBM MEDIZINTECHNIK GMBH, Sulz am Neckar, Germany) and adjusted to 25 cmH 2 O 8 . Body temperature was monitored using an esophageal temperature probe and maintained at approximately 36 °C using a forced-air warmer.…”

Section: Methodsmentioning

confidence: 99%

“…Sore throat and hoarseness was assessed at 1, 6, and 24 h after surgery by investigators unaware of the group allocation 8 . The severity of sore throat was evaluated using a 100-point numerical rating scale scored from 0 (no pain) to 100 (worst pain imaginable).…”

mentioning

confidence: 99%

“…Hoarseness was defined as a voice quality change different from the preoperative voice and graded as follows: none (no hoarseness), mild (recognized by the patient), moderate (obvious to the investigator), and severe (aphonia) 10 . The overall postoperative sore throat or hoarseness cases included patients who complained of sore throat or hoarseness over the 24-h evaluation period 8 . PCA fentanyl consumption and analgesic medications administered within 24 h after surgery were recorded accordingly.…”

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confidence: 99%

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Effect of intraoperative neuromuscular blockade on postoperative sore throat and hoarseness in patients undergoing spinal surgery: a prospective observational study

Won

Chang

Kim

et al. 2020

Sci Rep

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Intraoperative neuromuscular blockade affects the resting tension between the vocal cords. We assessed the effect of neuromuscular blockade on postoperative sore throat and hoarseness following tracheal intubation in patients undergoing lumbar spinal surgery in the prone position. Altogether, 99 patients were included; 50 patients did not receive neuromuscular blockade, and 49 patients received moderate neuromuscular blockade during the maintenance of anesthesia. Neuromuscular blockade was performed depending on the use of intraoperative neurophysiological monitoring. The number of intubation attempts, time to achieve tracheal intubation, and duration of intubation were recorded accordingly. The incidence and severity of postoperative sore throat and hoarseness was assessed at 1, 6, and 24 h after surgery. The overall cumulative incidence of postoperative sore throat (60% vs. 59%, respectively; P = 1.000) and postoperative hoarseness (68% vs. 61%, respectively; P = 0.532) did not differ between the no neuromuscular blockade and moderate neuromuscular blockade. The incidence and severity of postoperative sore throat and hoarseness was also not different between the moderate and no neuromuscular blockade at each time point after surgery. Nevertheless, the incidences of postoperative sore throat and hoarseness were quite high. Further studies investigating strategies to alleviate them are warranted accordingly.

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“…However, this method requires more experienced anesthesiologists, with the prerequisite of them having conducted more than 100 single-lumen tube and 30 DLT optical stylet-assisted intubations [ 5 ]. Furthermore, the structure of these researched video stylets and the consequences are perplexing: a short stylet requires a modification to the DLT by cutting the top to facilitate intubation, or a one-sided monitor that creates a tilting force, which is an obstacle for intubation [ 5 , 6 , 9 ]. The UE ® RVS (Newton, MA, USA) has a monitor in the center connected to a non-bendable stylet which is long enough (a length of 400 mm, a diameter of 5.2 mm, and an angle of 80°) to avoid need for the modification and tilting force ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Study of Rigid Video Stylet versus Macintosh Laryngoscope for Double-Lumen Endobronchial Tube Intubation Assistance in Thoracoscopic Pulmonary Surgery

Zhou

et al. 2023

JCM

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Double-lumen endobronchial tube (DLT) intubation is more challenging than single-lumen tube intubation is, and the rigid video stylet (RVS) is one of the tools that has emerged to deal with this demanding intubation procedure. We evaluated whether the UE® RVS can shorten the DLT intubation time and improve the first-attempt intubation success rate compared with that of Macintosh laryngoscope (ML). A total of 130 participants scheduled to undergo thoracoscopic pulmonary surgeries were enrolled. They were randomized to receive either ML- or RVS-assisted DLT intubation. The primary outcomes were the intubation time and first-attempt intubation success rate. The secondary outcomes were the overall intubation success rate, mean arterial pressure, postoperative sore throat (POST), and postoperative hoarseness at 1 h and 24 h. Compared with the ML group, the intubation time was significantly shorter in the RVS group (p < 0.001; 30.82 ± 10.61 vs. 39.62 ± 6.54 s), however, the first-attempt success rate was significantly lower (p = 0.048; 83.08% vs. 95.16%). The POST at 1 h was less severe in the RVS group (p = 0.021). No significant differences were found for the other indicators. Among the patients with normal airways, the UE® RVS can achieve faster DLT intubation and decrease the severity of a POST at 1 h, although it was associated with a lower first-attempt intubation success rate.

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A Randomized Controlled Trial Comparing the Utility of Lighted Stylet and GlideScope for Double-Lumen Endobronchial Intubation

Cited by 6 publications

References 19 publications

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Effect of intraoperative neuromuscular blockade on postoperative sore throat and hoarseness in patients undergoing spinal surgery: a prospective observational study

A Randomized Study of Rigid Video Stylet versus Macintosh Laryngoscope for Double-Lumen Endobronchial Tube Intubation Assistance in Thoracoscopic Pulmonary Surgery

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