Flexible Bronchoscope versus Video Laryngoscope for Orotracheal Intubation During Upper Gastrointestinal Endoscopic Surgery in Left Lateral Position: A Randomized Controlled Trial

Abstract

Purpose Endoscopic submucosal dissection (ESD) has become the primary treatment for early upper gastrointestinal tract lesions. During endoscopic surgery, endotracheal intubation is generally performed in the patients’ supine position, and patients are shifted to the left lateral position for endoscopic surgery. This study compared the efficacy of flexible bronchoscope-guided intubation with that of video laryngoscope-guided intubation in the left lateral position. Patients and Methods Forty-eight patients receiving ESD were randomly divided into the flexible bronchoscope group (group F) or the video laryngoscope group (group V). Tracheal intubation was performed by a trained anesthetist with a flexible bronchoscope (group F) or unchanneled video laryngoscope (group V) in the left lateral position. Primary outcomes included the intubation duration and success rate. Secondary outcomes included the ease of intubation technique and the occurrence of complications. Results Twenty-four (100%) patients in group F and twenty-three (95.8%) in group V were successfully intubated ( P = 1.000). The median intubation time in group F was 37s (interquartile range, 33.0, 44.5), which was significantly shorter compared to group V (53s [45.5, 66.5]; P < 0.001). The flexible bronchoscope was significantly easier to manage than the video laryngoscope, as reflected by the users scoring system (9 [9, 10] vs 8 [7, 8]; P < 0.001). The presence of perioperative adverse events and complications were comparable between the two groups. Conclusion Both flexible bronchoscope- and video laryngoscope-guided intubation in patients’ left lateral position achieved high success rates and comparable complication rates. However, intubation with the flexible bronchoscope was completed more quickly.

Identifying the Risk Factors for Postoperative Sore Throat After Endotracheal Intubation for Oral and Maxillofacial Surgery

“… 1 Endotracheal intubation is an essential operation to secure airway patency and reduce gastric reflux and pulmonary aspiration risk. 2 General anesthesia with endotracheal intubation is overall safe but has countless complications, which may affect the general condition of patients and prolong the postoperative hospital stay. 3 The incidence of postoperative complications might be related to surgical procedures and general physical health.…”

Learning curve for flexible bronchoscope-guided orotracheal intubation for anesthesiology residents: A cumulative sum analysis

“…Endotracheal intubation is an essential skill for anesthesiologists, who must be familiar with various airway management devices and techniques. The flexible bronchoscope is a well-recognized airway management technique that is part of every difficult airway management algorithm and the gold standard for the management of most difficult airways [1][2][3][4]. The flexible bronchoscope provides operators "look around the corner" vision and high first-attempt intubation success, and is safe and well tolerated by patients [5][6][7].…”