Comparative study of fiber-optic guided tracheal intubation through intubating laryngeal mask airway LMA Fastrach™ and i-gel in adult paralyzed patients.

Airway seal pressure LMA Fastrach endotracheal tube fiberoptic intubation i-gel

Journal

Saudi journal of anaesthesia
ISSN: 1658-354X
Titre abrégé: Saudi J Anaesth
Pays: India
ID NLM: 101500601

Informations de publication

Date de publication:
Historique:
entrez: 2 10 2019
pubmed: 2 10 2019
medline: 2 10 2019
Statut: ppublish

Résumé

The i-gel is a novel and innovative supraglottic airway management device used both as an airway rescue device and as a conduit for fiberoptic intubation. In this prospective randomized study, we compared fiberoptic-guided tracheal intubation through the i-gel and LMA Fastrach™ in adult paralyzed patients. After ethical committee approval and written informed consent, 60 patients of either sex were randomly allocated to either group of supraglottic airway device (SGAD). After successful insertion of the SGAD, the fiberoptic bronchoscope (FOB)-guided tracheal intubation was done through the respective SGAD. The primary objectives were the ease and time taken for fiberoptic-guided intubation in either group. Secondary variables included time taken for successful placement of SGAD, ease of insertion of SGAD, airway seal pressure, ease and time of removal of SGAD, variation in hemodynamic parameters, and complications if any. Time taken for tracheal intubation in LMA Fastrach™ group was 69.53 ± 5.09 s and for the i-gel group it was 72.33 ± 6.73 s. It was seen that it was easy to insert the endotracheal tube (ETT) in 93.3% patients in the LMA Fastrach™ group and 96.7% patients in the i-gel group. Airway seal pressure was higher for the LMA Fastrach™ group. Both the SGADs were comparable in the number of attempts of insertion, ease of insertion, and insertion time. In addition, the hemodynamic variables noted did not show any increase after insertion of SGAD. There was no difficulty encountered in removal of either SGAD. I-gel may be a reliable and cost-effective alternative to LMA Fastrach™ for fibreoptic-guided tracheal intubation.

Sections du résumé

BACKGROUND BACKGROUND
The i-gel is a novel and innovative supraglottic airway management device used both as an airway rescue device and as a conduit for fiberoptic intubation. In this prospective randomized study, we compared fiberoptic-guided tracheal intubation through the i-gel and LMA Fastrach™ in adult paralyzed patients.
MATERIALS AND METHODS METHODS
After ethical committee approval and written informed consent, 60 patients of either sex were randomly allocated to either group of supraglottic airway device (SGAD). After successful insertion of the SGAD, the fiberoptic bronchoscope (FOB)-guided tracheal intubation was done through the respective SGAD. The primary objectives were the ease and time taken for fiberoptic-guided intubation in either group. Secondary variables included time taken for successful placement of SGAD, ease of insertion of SGAD, airway seal pressure, ease and time of removal of SGAD, variation in hemodynamic parameters, and complications if any.
RESULTS RESULTS
Time taken for tracheal intubation in LMA Fastrach™ group was 69.53 ± 5.09 s and for the i-gel group it was 72.33 ± 6.73 s. It was seen that it was easy to insert the endotracheal tube (ETT) in 93.3% patients in the LMA Fastrach™ group and 96.7% patients in the i-gel group. Airway seal pressure was higher for the LMA Fastrach™ group. Both the SGADs were comparable in the number of attempts of insertion, ease of insertion, and insertion time. In addition, the hemodynamic variables noted did not show any increase after insertion of SGAD. There was no difficulty encountered in removal of either SGAD.
CONCLUSION CONCLUSIONS
I-gel may be a reliable and cost-effective alternative to LMA Fastrach™ for fibreoptic-guided tracheal intubation.

Identifiants

pubmed: 31572071
doi: 10.4103/sja.SJA_707_18
pii: SJA-13-290
pmc: PMC6753755
doi:

Types de publication

Journal Article

Langues

eng

Pagination

290-294

Informations de copyright

Copyright: © 2019 Saudi Journal of Anesthesia.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

Br J Anaesth. 2002 Apr;88(4):534-9
pubmed: 12066730
Br J Anaesth. 1983 Aug;55(8):801-5
pubmed: 6349667
J Coll Physicians Surg Pak. 2012 Jul;22(7):419-23
pubmed: 22747859
Indian J Anaesth. 2014 Jul;58(4):397-402
pubmed: 25197106
Anesthesiology. 2000 Jul;93(1):104-9
pubmed: 10861152
Br J Anaesth. 2011 Aug;107(2):243-50
pubmed: 21652615
Anaesthesia. 2008 Sep;63(9):991-5
pubmed: 18557971
Anaesthesia. 2005 Oct;60(10):1022-6
pubmed: 16179048
Br J Anaesth. 2011 Aug;107(2):251-7
pubmed: 21652616

Auteurs

Suvidha Sood (S)

Department of Anaesthesiology, ESI-PGIMSR, Basaidarapur, New Delhi, India.

Anupriya Saxena (A)

Department of Anaesthesiology, ESI-PGIMSR, Basaidarapur, New Delhi, India.

Anil Thakur (A)

Department of Anaesthesiology, ESI-PGIMSR, Basaidarapur, New Delhi, India.

Shikha Chahar (S)

Department of Anaesthesiology, ESI-PGIMSR, Basaidarapur, New Delhi, India.

Classifications MeSH