Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients

Detalhes bibliográficos
Autor(a) principal: Ranieri Júnior, Dante
Data de Publicação: 2014
Outros Autores: Zinelli, Fabio Riefel, Neubauer, Adecir Geraldo, Schneider, Andre P., Nascimento Junior, Paulo do [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1016/j.bjane.2012.07.004
http://hdl.handle.net/11449/130693
Resumo: Purpose this study investigated the influence of anatomical predictors on difficult laryngoscopy and orotracheal intubation in obese patients by comparing Macintosh and Airtraq™ laryngoscopes. Methods from 132 bariatric surgery patients (body mass index ≥ 35 kg m−1), cervical perimeter, sternomental distance, interincisor distance, and Mallampati score were recorded. The patients were randomized into two groups according to whether a Macintosh (n = 64) or an Airtraq™ (n = 68) laryngoscope was used for tracheal intubation. Time required for intubation was the first outcome. Cormack–Lehane score, number of intubation attempts, the Macintosh blade used, any need for external tracheal compression or the use of gum elastic bougie were recorded. Intubation failure and strategies adopted were also registered. Results intubation failed in two patients in the Macintosh laryngoscope group, and these patients were included as worst cases scenario. The intubation times were 36.9 + 22.8 s and 13.7 + 3.1 s for the Macintosh and Airtraq™ laryngoscope groups (p < 0.01), respectively. Cormack–Lehane scores were also lower for the Airtraq™ group. One patient in the Macintosh group with intubation failure was quickly intubated with the Airtraq™. Cervical circumference (p < 0.01) and interincisor distance (p < 0.05) influenced the time required for intubation in the Macintosh group but not in the Airtraq™ group. Conclusion in obese patients despite increased neck circumference and limited mouth opening, the Airtraq™ laryngoscope affords faster tracheal intubation than the Macintosh laryngoscope, and it may serve as an alternative when conventional laryngoscopy fails.
id UNSP_94be921b917804dca57fd510f409807b
oai_identifier_str oai:repositorio.unesp.br:11449/130693
network_acronym_str UNSP
network_name_str Repositório Institucional da UNESP
repository_id_str 2946
spelling Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patientsDatos de evaluación preanestésica no influyen en el tiempo de intubación traqueal con el videolaringoscopio Airtraq(r) en pacientes obesosDados da avaliação pré-anestésica não influenciam o tempo de intubação com o videolaringoscópio Airtraq(r) em pacientes obesosObesityIntubationLaryngoscopyAirtraq(tm)ObesidadeIntubaçãoLaringoscopiaAirtraq(r)Purpose this study investigated the influence of anatomical predictors on difficult laryngoscopy and orotracheal intubation in obese patients by comparing Macintosh and Airtraq™ laryngoscopes. Methods from 132 bariatric surgery patients (body mass index ≥ 35 kg m−1), cervical perimeter, sternomental distance, interincisor distance, and Mallampati score were recorded. The patients were randomized into two groups according to whether a Macintosh (n = 64) or an Airtraq™ (n = 68) laryngoscope was used for tracheal intubation. Time required for intubation was the first outcome. Cormack–Lehane score, number of intubation attempts, the Macintosh blade used, any need for external tracheal compression or the use of gum elastic bougie were recorded. Intubation failure and strategies adopted were also registered. Results intubation failed in two patients in the Macintosh laryngoscope group, and these patients were included as worst cases scenario. The intubation times were 36.9 + 22.8 s and 13.7 + 3.1 s for the Macintosh and Airtraq™ laryngoscope groups (p < 0.01), respectively. Cormack–Lehane scores were also lower for the Airtraq™ group. One patient in the Macintosh group with intubation failure was quickly intubated with the Airtraq™. Cervical circumference (p < 0.01) and interincisor distance (p < 0.05) influenced the time required for intubation in the Macintosh group but not in the Airtraq™ group. Conclusion in obese patients despite increased neck circumference and limited mouth opening, the Airtraq™ laryngoscope affords faster tracheal intubation than the Macintosh laryngoscope, and it may serve as an alternative when conventional laryngoscopy fails.Objetivo esse estudo investigou a influência de preditores anatômicos para laringoscopia e intubação orotraqueal difícil em pacientes obesos mediante a comparação dos laringoscópios Macintosh e Airtraq®. Métodos em 132 pacientes de cirurgia bariátrica foram registrados: perímetro cervical, distância esternomentoniana, distância inter‐incisivos e escore de Mallampati. Os pacientes foram randomizados em dois grupos, de acordo com o laringoscópio usado para a intubação traqueal: Macintosh (n = 64) ou Airtraq® (n = 68). O tempo até a intubação foi o primeiro desfecho. Também foram registrados: escore de Cormack‐Lehane, número de tentativas de intubação, lamina Macintosh usada, necessidade de compressão traqueal externa, ou uso de um bougie elástico de borracha. Também foram anotados o insucesso na intubação e as estratégias adotadas. Resultados houve insucesso na intubação em dois pacientes no grupo com laringoscópio de Macintosh; esses pacientes foram incluídos como o pior cenário de caso. Os tempos para intubação foram 36,9 ± 22,8 seg e 13,7 ± 3,1 seg para os grupos Macintosh e Airtraq® (p < 0,01), respectivamente. Os escores de Cormack‐Lehane também foram mais baixos para o grupo Airtraq®. Um paciente no grupo Macintosh com insucesso na intubação foi rapidamente intubado com o laringoscópio Airtraq®. A circunferência cervical (p < 0,01) e a distância inter‐incisivos (p < 0,05) influenciaram o tempo até a intubação no grupo Macintosh, mas não no grupo Airtraq®. Conclusão em pacientes obesos, apesar da maior circunferência cervical e da limitada abertura da boca, o laringoscópio Airtraq® possibilita uma intubação traqueal mais rápida versus laringoscópio Macintosh, podendo funcionar como alternativa, nos casos de insucesso com a laringoscopia convencional.Objetivo el objetivo de este estudio fue evaluar la influencia de los predictores anatómicos en la laringoscopia e intubación orotraqueal difíciles en pacientes obesos comparando el laringoscopio Macintosh y el videolaringoscopio Airtraq®. Métodos en 132 pacientes sometidos a cirugía bariátrica (índice de masa corporal ≥ 35 kg/m2), se registraron los valores de perímetro cervical, distancia mentoesternal, distancia interincisivos y puntuación de Mallampati. Los pacientes fueron aleatorizados en 2 grupos de acuerdo con el uso de los laringoscopios Macintosh (n = 64) o Airtraq® (n = 68) para intubación traqueal. El resultado primario fue el tiempo necesario para la intubación. Se registraron la puntuación de Cormack-Lehane, el número de intentos de intubación, el uso de lámina Macintosh y cualquier necesidad de compresión traqueal externa o la utilización de introductor del tubo traqueal. Las estrategias de intubación adoptadas y los fallos de las intubaciones también fueron recogidos en el informe. Resultados en el grupo Macintosh, 2 pacientes presentaron fallo en la intubación y fueron incluidos como los peores casos de intubación. Los tiempos de intubación fueron 36,9 ± 22,8 s y 13,7 ± 3,1 s para los grupos Macintosh y Airtraq® (p < 0,01), respectivamente. Las puntuaciones de Cormack-Lehane también fueron menores para el grupo Airtraq®. Un paciente del grupo Macintosh con fallo de intubación fue rápidamente intubado con el Airtraq®. La circunferencia cervical (p < 0,01) y la distancia interincisivos (p < 0,05) influyeron en el tiempo necesario para la intubación en el grupo Macintosh, pero no en el grupo Airtraq®. Conclusión en los pacientes obesos, a pesar del aumento de la circunferencia del cuello y de la abertura limitada de la boca, el laringoscopio Airtraq® ofrece una intubación traqueal más rápida que el laringoscopio Macintosh, pudiendo servir como una alternativa cuando la laringoscopia convencional falle.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Hospital do Coração de Balneário Camboriu Department of AnesthesioloyUnesp Falcudade de Mediciana de Botucatu Department of AnesthesioloyUniv Estadual Paulista, Fac Med Botucatu, Dept Anesthesiol, Sao Paulo, SC, BrazilSociedade Brasileira de AnestesiologiaHosp Coracao Balneario CamboriuUniversidade Estadual Paulista (Unesp)Ranieri Júnior, DanteZinelli, Fabio RiefelNeubauer, Adecir GeraldoSchneider, Andre P.Nascimento Junior, Paulo do [UNESP]2015-02-02T12:39:33Z2015-02-02T12:39:33Z2014-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article190-194application/pdfapplication/pdfapplication/pdfhttp://dx.doi.org/10.1016/j.bjane.2012.07.004Revista Brasileira de Anestesiologia. Sociedade Brasileira de Anestesiologia, v. 64, n. 3, p. 190-194, 2014.0034-7094http://hdl.handle.net/11449/13069310.1016/j.bjane.2012.07.004S0034-70942014000300190WOS:000339139300009S0034-70942014000300190.pdf87453589896806000000-0002-2323-9159SciELOreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengRevista Brasileira de Anestesiologia0.8500,320info:eu-repo/semantics/openAccess2024-08-14T13:20:26Zoai:repositorio.unesp.br:11449/130693Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T13:20:26Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
Datos de evaluación preanestésica no influyen en el tiempo de intubación traqueal con el videolaringoscopio Airtraq(r) en pacientes obesos
Dados da avaliação pré-anestésica não influenciam o tempo de intubação com o videolaringoscópio Airtraq(r) em pacientes obesos
title Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
spellingShingle Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
Ranieri Júnior, Dante
Obesity
Intubation
Laryngoscopy
Airtraq(tm)
Obesidade
Intubação
Laringoscopia
Airtraq(r)
title_short Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
title_full Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
title_fullStr Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
title_full_unstemmed Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
title_sort Preanesthetic assessment data do not influence the time for tracheal intubation with Airtraq (TM) video laryngoscope in obese patients
author Ranieri Júnior, Dante
author_facet Ranieri Júnior, Dante
Zinelli, Fabio Riefel
Neubauer, Adecir Geraldo
Schneider, Andre P.
Nascimento Junior, Paulo do [UNESP]
author_role author
author2 Zinelli, Fabio Riefel
Neubauer, Adecir Geraldo
Schneider, Andre P.
Nascimento Junior, Paulo do [UNESP]
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Hosp Coracao Balneario Camboriu
Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Ranieri Júnior, Dante
Zinelli, Fabio Riefel
Neubauer, Adecir Geraldo
Schneider, Andre P.
Nascimento Junior, Paulo do [UNESP]
dc.subject.por.fl_str_mv Obesity
Intubation
Laryngoscopy
Airtraq(tm)
Obesidade
Intubação
Laringoscopia
Airtraq(r)
topic Obesity
Intubation
Laryngoscopy
Airtraq(tm)
Obesidade
Intubação
Laringoscopia
Airtraq(r)
description Purpose this study investigated the influence of anatomical predictors on difficult laryngoscopy and orotracheal intubation in obese patients by comparing Macintosh and Airtraq™ laryngoscopes. Methods from 132 bariatric surgery patients (body mass index ≥ 35 kg m−1), cervical perimeter, sternomental distance, interincisor distance, and Mallampati score were recorded. The patients were randomized into two groups according to whether a Macintosh (n = 64) or an Airtraq™ (n = 68) laryngoscope was used for tracheal intubation. Time required for intubation was the first outcome. Cormack–Lehane score, number of intubation attempts, the Macintosh blade used, any need for external tracheal compression or the use of gum elastic bougie were recorded. Intubation failure and strategies adopted were also registered. Results intubation failed in two patients in the Macintosh laryngoscope group, and these patients were included as worst cases scenario. The intubation times were 36.9 + 22.8 s and 13.7 + 3.1 s for the Macintosh and Airtraq™ laryngoscope groups (p < 0.01), respectively. Cormack–Lehane scores were also lower for the Airtraq™ group. One patient in the Macintosh group with intubation failure was quickly intubated with the Airtraq™. Cervical circumference (p < 0.01) and interincisor distance (p < 0.05) influenced the time required for intubation in the Macintosh group but not in the Airtraq™ group. Conclusion in obese patients despite increased neck circumference and limited mouth opening, the Airtraq™ laryngoscope affords faster tracheal intubation than the Macintosh laryngoscope, and it may serve as an alternative when conventional laryngoscopy fails.
publishDate 2014
dc.date.none.fl_str_mv 2014-06-01
2015-02-02T12:39:33Z
2015-02-02T12:39:33Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1016/j.bjane.2012.07.004
Revista Brasileira de Anestesiologia. Sociedade Brasileira de Anestesiologia, v. 64, n. 3, p. 190-194, 2014.
0034-7094
http://hdl.handle.net/11449/130693
10.1016/j.bjane.2012.07.004
S0034-70942014000300190
WOS:000339139300009
S0034-70942014000300190.pdf
8745358989680600
0000-0002-2323-9159
url http://dx.doi.org/10.1016/j.bjane.2012.07.004
http://hdl.handle.net/11449/130693
identifier_str_mv Revista Brasileira de Anestesiologia. Sociedade Brasileira de Anestesiologia, v. 64, n. 3, p. 190-194, 2014.
0034-7094
10.1016/j.bjane.2012.07.004
S0034-70942014000300190
WOS:000339139300009
S0034-70942014000300190.pdf
8745358989680600
0000-0002-2323-9159
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Revista Brasileira de Anestesiologia
0.850
0,320
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 190-194
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Sociedade Brasileira de Anestesiologia
publisher.none.fl_str_mv Sociedade Brasileira de Anestesiologia
dc.source.none.fl_str_mv SciELO
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv
_version_ 1808128147599654912