Document Detail

Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients.
MedLine Citation:
PMID:  19233881     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Berci-Kaplan video laryngoscope was developed to improve the visualization of the glottis and ease tracheal intubation. Whether this technique is also effective in patients with an expected difficult intubation is unclear. We have prospectively evaluated the conditions and success rate of tracheal intubation in patients with a Mallampati score of III or IV. METHODS: Two hundred patients, undergoing general anaesthesia, were randomized to be intubated using direct laryngoscopy (n=100) or video laryngoscopy (n=100). Visualization of the vocal cords, success rate, time for intubation, and the need for additional manoeuvres (laryngeal manipulations, head positioning, and Eschmann stylet) were evaluated. RESULTS: Video laryngoscopy produced better results for the visualization of the glottis using Cormack and Lehane criteria (P<0.001), success rate (n=92 vs 99, P=0.017), and the time for intubation [60 (77) vs 40 (31) s, P=0.0173]. In addition, the number of optimizing manoeuvres was also significantly decreased [1.2 (1.3) vs 0.5 (0.7), P<0.001]. CONCLUSIONS: Video laryngoscopy, when compared with direct laryngoscopy for difficult intubations, provides a significantly better view of the cords, a higher success rate, faster intubations, and less need for optimizing manoeuvres. Therefore, we feel that the video laryngoscopy leads to a clinically relevant improvement of intubation conditions and can be recommended for difficult airway management.
A Jungbauer; M Schumann; V Brunkhorst; A Börgers; H Groeben
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-02-20
Journal Detail:
Title:  British journal of anaesthesia     Volume:  102     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-16     Completed Date:  2009-04-14     Revised Date:  2009-06-24    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  546-50     Citation Subset:  IM    
Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Clinics Essen-Mitte, Henricistr. 92, 45136 Essen, Germany.
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MeSH Terms
Aged, 80 and over
Anesthesia, General
Head Movements
Intubation, Intratracheal / instrumentation,  methods*
Laryngoscopy / methods*
Middle Aged
Prospective Studies
Video Recording
Young Adult
Comment In:
Br J Anaesth. 2009 Jul;103(1):134-5; author reply 135   [PMID:  19546205 ]

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