Endotracheal intubation: ultrasound-guided versus fiberscope in patients with cervical spine immobilization
| Autor: | Emad Arida, Ola M. Zanaty, Sameh Fathy El-tamboly, Moustafa Abdelaziz Moustafa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Tracheal intubation Ultrasound 030208 emergency & critical care medicine respiratory system law.invention Surgery 03 medical and health sciences Intubation procedure 0302 clinical medicine Anesthesiology and Pain Medicine 030202 anesthesiology law Anesthesia Anesthesiology Anesthetic medicine Fiberscope Intubation Airway management business medicine.drug |
| Zdroj: | Journal of Anesthesia. 31:846-851 |
| ISSN: | 1438-8359 0913-8668 |
| Popis: | Ultrasound has growing applications in airway management during anesthesia. The aim of the present study was to evaluate the feasibility of real-time ultrasound-guided tracheal intubation in patients with cervical spine immobilization relative to fiberscope-guided tracheal intubation. This randomized controlled study was carried out on 266 adult patients who have a rigid neck collar in place for cervical spine immobilization and were randomly allocated into two equal groups. All patients were subjected to the same anesthetic protocol. After full neuromuscular blockade, neck collar was removed and tracheal intubation was done in the neutral position. In group A, the trachea was intubated guided by a 5–12-MHz linear ultrasound probe attached to a Sonoscape A5 ultrasound machine. In group B, the trachea was intubated by an endotracheal tube mounted over a fiberscope (Karl Storz, working length 65 cm, distal tip diameter 5.6 mm). Hemodynamic measurements and oxygen saturation were recorded. Tracheal intubation criteria for both groups including duration of the intubation procedure, number of intubation attempts, success rate at each attempt, and the lowest oxygen saturation recorded during tracheal intubation were recorded. Ultrasound and fiberscope achieved comparable time for tracheal intubation (57 ± 12 vs. 55 ± 10 s), respectively. Success rate of tracheal intubation at the first attempt was higher in the fiberscope group than the ultrasound group, with a P value of 0.032. The overall success rate was not significantly different between the two groups. Ultrasound-guided tracheal intubation showed a lower first attempt success rate in patients with cervical spine immobilization compared to fiberscope-guided tracheal intubation but the overall success rates were comparable. Ultrasound can be an alternative technique for guiding tracheal intubation in patients with cervical spine immobilization. PACTR201602001476292. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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