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Endotracheal intubation in patients undergoing open abdominal surgery in the lateral position: a comparison between the intubating video stylet and fiberoptic intubating bronchoscopy

대한마취과학회지 2021년 74권 3호 p.234 ~ 241
Wahdan Amr Samir, El-Refai Nesrine Abdel Rahman, Omar Sohaila Hussien, Moneem Shady Amr Abdel, Mohamed Mennatallah Magdi, Hussien Mohamed Mahmoud,
소속 상세정보
 ( Wahdan Amr Samir ) - Cairo University Faculty of Medicine Department of Anesthesia
 ( El-Refai Nesrine Abdel Rahman ) - Cairo University Faculty of Medicine Department of Anesthesia
 ( Omar Sohaila Hussien ) - Theodor Bilharz Research Institute Department of Anesthesia
 ( Moneem Shady Amr Abdel ) - Theodor Bilharz Research Institute Department of Anesthesia
 ( Mohamed Mennatallah Magdi ) - Cairo University Faculty of Medicine Department of Anesthesia
 ( Hussien Mohamed Mahmoud ) - Theodor Bilharz Research Institute Department of Anesthesia

Abstract


Background: Some situations compel anesthetists to execute endotracheal intubation in the lateral position. We compared elective endotracheal intubation in the lateral decubitus position using the video stylet (VS) device with the fiberoptic (FO) bronchoscope device in patients undergoing abdominal surgery.

Methods: Overall, 50 patients were enrolled in this prospective, randomized study. They were randomly classified into the VS intubation or FO intubating bronchoscope group. After anesthesia induction, patients were placed in the lateral decubitus position, and a single investigator well-versed with the use of the VS and FO bronchoscope performed the intubation. The primary outcome was the time taken for intubation. Secondary outcomes included the intubation success rate, hemodynamic response at specific time points and perioperative complications.

Results: The average time taken for intubation was significantly lesser in the VS group than in the FO group, with values of 39.5 ± 10.0 and 75.6 ± 16.2 s, respectively (P < 0.001). Incidences of a successful first attempt of intubation in the VS and FO groups were 88% and 100%, respectively, showing no significant difference. There was a negligible difference in complications between the groups, except sore throat, which showed a higher incidence in the VS group than in the FO group (P = 0.002).

Conclusions: In laterally positioned patients, elective endotracheal intubation with VS provides less intubation time; however, its use is accompanied by a significant increase in the hemodynamic response after intubation and an increased incidence of sore throat.

키워드

Airway management; Bronchoscope; Intratracheal intubation; Laparotomy; Patient Positioning; Video stylet

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