Comparison of i-gel® and LMA® Supreme™ for Facilitating Fiberoptic Endotracheal Intubation: A Prospective Randomized Trial.

Autor: Lefevre RJ; is an Assistant Professor of Anesthesiology, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee. Email: ryan.lefevre@vumc.org., Jelly CA; is an Assistant Professor of Anesthesiology, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee. Email: christina.jelly@vumc.org., Schmelz C; is a CRNA at South Texas Veterans Health Care System, San Antonio, Texas. Email: cynthia.schmelz@va.gov., Bennett J; is an Anesthesiologist at Carolinas Medical Center, Charlotte, North Carolina. Email: resanesthesiologist@gmail.com., Shi Y; is a Biostatistician at Vanderbilt University Medical Center, Nashville, Tennessee. Email: yapping.shi@vumc.org., Shotwell M; is a Biostatistician at Vanderbilt University Medical Center, Nashville, Tennessee. Email: matt.shotwell@vumc.org., Ford J; is a CRNA at Vanderbilt University Medical Center, Nashville, Tennessee. Email: jeffrey.ford@vumc.org., Hernandez A; is a Professor of Anesthesiology at Vanderbilt University Medical Center, Nashville, Tennessee. Email: antonio. hernandez@vumc.org.
Jazyk: angličtina
Zdroj: AANA journal [AANA J] 2024 Jun; Vol. 92 (3), pp. 197-205.
Abstrakt: Supraglottic airway (SGA) is an alternative to endotracheal intubation, however endotracheal intubation is often essential. One method to convert from an SGA to an endotracheal tube (ETT) is utilizing the SGA as a conduit for fiberoptic-guided advancement of an Aintree catheter (airway exchange catheter), and exchange of the SGA for an ETT. In this prospective randomized study, we compared two SGA devices in facilitating this exchange. Subjects were randomized to receive either the i-gel® or LMA® Supreme™ SGA. The SGA was placed and an Aintree intubation catheter was inserted through the SGA over a fiberoptic bronchoscope. Next, the SGA was removed, leaving the Aintree within the trachea, and an ETT was placed over the Aintree catheter and advanced into the trachea. The i-gel group exhibited shorter time to successful intubation (median, 191 vs. 434 seconds; P = .002). The i-gel group also had fewer study subjects requiring more than one attempt for successful Aintree placement (33% vs. 75%, P = .02). The i-gel group showed superior laryngeal view score (LVS) (6 vs. 4; P = .003). The i-gel SGA achieved a faster time to successful intubation, higher rate of first attempt Aintree placement, and superior LVS.
Competing Interests: Name: Ryan J. Lefevre, MD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. He is the corresponding author of this article. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Christina A. Jelly, MD, MS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Cynthia Schmelz, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Jeremy Bennett, MD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Yaping Shi, MS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Matthew Shotwell, PhD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Jeffrey Ford, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas. Name: Antonio Hernandez, MD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Funding from the Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee and the Department of Anesthesiology, South Texas Veterans Health Care System, San Antonio, Texas.
(Copyright © by the American Association of Nurse Anesthetists.)
Databáze: MEDLINE
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