The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient

Maassen, R.; Lee, Ruben; Zundert, André van; Cooper, Richard M.

doi:10.1007/s00540-009-0780-1

Cited by 50 publications

(33 citation statements)

References 25 publications

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“…The results of their manikin study are congruent to several studies we have published [2][3][4], in which we clinically tested the performance of the following three videolaryngoscopes: GlideScope …”

Section: S M Yentis Editor-in-chiefsupporting

confidence: 75%

“…The Difficult Airway Society has suggested the use of videolaryngoscopy in the management of the difficult airway [4] and there have been similar suggestions in the USA [5]. The APA videolaryngoscope offers users a familiar technique and in this case provided good laryngeal views and facilitated rapid but gentle intubation when performed by a practitioner new to its clinical use.…”

mentioning

confidence: 99%

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Correspondence: The anaesthetist and the environment

Coe

2010

Anaesthesia

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Section: S M Yentis Editor-in-chiefsupporting

confidence: 75%

mentioning

confidence: 99%

Correspondence: The anaesthetist and the environment

Coe

2010

Anaesthesia

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“…Hence, laryngoscopy performed using a VL has proven to provide superior views compared to direct laryngoscopy in both normal and difficult intubation situations [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Utilization of C-MAC videolaryngoscopy for direct and indirect assisted endotracheal intubation

Cattano¹,

Ferrario²,

Maddukuri³

et al. 2013

J Anesthesiol Clin Sci

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Background: The experiences of seasoned practitioners with the new C-MAC indirect videolaryngoscope system have shown promising results in the management of difficult airways. However, a comparison of direct and indirect laryngoscopy utilizing the C-MAC system as its own control has not been performed in a cohort of anesthesiologists-in-training. The primary aim was to compare direct and indirect laryngoscopy in terms of intubation time with secondary outcomes including laryngoscopy time and airway view with the same size 3 blade. Methods: The study was registered with www.clinicaltrials.gov (NCT01104090). Oral and written informed consent was obtained from 50 adult patients with BMI < 40 kg/m 2 who required general anesthesia for elective surgery with tracheal tube placement. The patients were randomized to two groups, each receiving two laryngoscopies, n=25 direct-first and n=25 indirect-first. Results: All patients except for one were successfully intubated on the first attempt. The intubation time was 12.3±11.1 sec immediately following videolaryngoscopy (direct laryngoscopy first group) and 9.8±7.1 sec immediately following direct laryngoscopy (videolaryngoscopy first group), p=0.35. The first laryngoscopy time was 8.7±4.7 sec in the direct group and 13.3±10.7 sec in the indirect group, p=0.06. Twenty-percent of direct first cases compared to 0% of indirect first cases showed an improvement in airway view score by at least two classes on the second laryngoscopy, p=0.02. Backward-upward-rightward pressure was used in 36% of direct first and 12% of indirect first patients, p=0.047. Conclusions: This study corroborates previous results on the use of the C-MAC videolaryngoscopy system during endotracheal-assisted intubation. Although there was no difference in intubation time between direct laryngoscopy and videolaryngoscopy, the C-MAC system was found to improve laryngeal views and reduce the number of necessary laryngeal manipulations. A larger randomized study utilizing a similar model is necessary to definitively determine significant clinical results.

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“…The use of videolaryngoscopes in morbidly obese patients not only improves the glottic view but also makes intubation efforts easier and less traumatic [6]. Therefore, although obesity is not necessarily associated with a higher probability of difficult intubation, endotracheal intubation in morbidly obese patients requires skill and usually more strength.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience with the C-Mac videolaryngoscope in morbidly obese patients

Gaszyński

2014

Anaesthesiol Intensive Ther

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Background: The use of videolaryngoscopes is recommended as a part of routine practice in anaesthesia for morbidly obese patients. The aim of this study was to evaluate C-Mac in a group of morbidly obese patients to see if it improves intubation conditions. Methods: 86 morbidly obese (BMI > 40 kg m -2 ) patients scheduled for bariatric surgery were included in the study. In every studied case, C-Mac was used with a Mackintosh shaped blade. For the first attempt, the anaesthetists performing the intubation were asked to use a videolaryngoscope as a standard laryngoscope (they were blinded to the monitor display) and evaluate the glottic view in direct laryngoscopy. Then they were asked to look at the monitor of the videolaryngoscope and intubate the patient. The laryngoscopy conditions were evaluated using the Cormack--Lahane (CL) scale. The time from picking up the laryngoscope to inserting the endotracheal tube was recorded. Results: The evaluation of CL grade in direct laryngoscopy was: 44 patients -grade 1; 23 patients -grade 2; 13 patients -grade 3; six patients -grade 4. In all cases of CL grade > 1 in direct laryngoscopy, the use of C-Mac improved CL grade to 1. Mean time of intubation was 17.2 ± 2.5 sec. Conclusion: The C-Mac improves laryngeal view in morbidly obese patients, and allows for fast endotracheal intubation.

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The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient

Cited by 50 publications

References 25 publications

Correspondence: The anaesthetist and the environment

Correspondence: The anaesthetist and the environment

Utilization of C-MAC videolaryngoscopy for direct and indirect assisted endotracheal intubation

Clinical experience with the C-Mac videolaryngoscope in morbidly obese patients

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