Document Detail

A novel intubation technique in bilateral cleft palate pediatric patients: hard gum shield-aided intubation.
MedLine Citation:
PMID:  23189986     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cleft palate anesthesia is challenging due to difficult airway. Left paraglossal intubation moves resting point of laryngoscope laterally but associated with narrower laryngoscopic view and possible trauma, and we invented the use of hard gum shield as a bridge over defective palate to facilitate intubation with possible wider window and defective tissue protection.
METHODS: Eighty bilateral cleft palate children, ASA physical status I-II aged 9 months to 6 years scheduled for plastic surgery had general anesthesia, were involved in prospective, controlled, randomized study, and were randomly divided by closed envelope method into two groups: group I (40 patients): intubated by hard gum shield-aided intubation and group II (40 patients): intubated by left paraglossal intubation. Both techniques compared as regards (i) intubation time; (ii) Cormack and Lehane score; (iii) need for external laryngeal manipulation; (iv) easiness of intubation: easy, modest, or difficult intubation; and (v) complications: desaturation and failed intubation.
RESULTS: Intubation time was shorter in group I (28.47 ± 3.78 vs. 37.63 ± 6.64 s, P = 0.001). Cormack and Lehane score was better in group I (P = 0.003). Need for external laryngeal manipulation was less in group I (P = 0.015). Easiness of intubation was better in group I (P = 0.022). No difference was found in complications between groups.
CONCLUSION: Hard gum shield-aided intubation facilitated intubation more than left paraglossal in bilateral cleft palate children with shorter intubation time, better glottic view, easier intubation, less need for laryngeal manipulation than left paraglossal intubation with no difference in complications.
Ahmed Abdelaal Ahmed Mahmoud; Ahmed Zaghloul Fouad; Mohamed Ahmed Mansour; Ahmed Mostafa Kamal
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2012-11-28
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  23     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-08-30     Revised Date:  2013-10-16    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  349-54     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Department of Anesthesiology, Beni Suef University, Beni Suef, Egypt.
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MeSH Terms
Airway Management
Carbon Dioxide / blood
Child, Preschool
Cleft Palate / surgery*
Intubation, Intratracheal / instrumentation*,  methods*
Monitoring, Intraoperative
Prospective Studies
Sample Size
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comment In:
Paediatr Anaesth. 2013 Oct;23(10):962-3   [PMID:  24004153 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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