Flexible bronchoscopic intubation through the AuraGain™ laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial
| Autor: | Heinz R. Bruppacher, Berthold Moser, Laurent Audigé, Joseph Brimacombe, Christian Keller, Lukas Gasteiger |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Laryngeal Masks law.invention 03 medical and health sciences 0302 clinical medicine Bronchoscopy Randomized controlled trial 030202 anesthesiology law medicine Intubation Intratracheal Intubation Humans Knee Single-Blind Method Aged Hip surgery Neck pain Hip Hoarseness Neck Pain medicine.diagnostic_test business.industry 030208 emergency & critical care medicine General Medicine Middle Aged Dysphagia Confidence interval Surgery Anesthesiology and Pain Medicine Anesthesia Female medicine.symptom business Deglutition Disorders Follow-Up Studies |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 64(11) |
| ISSN: | 1496-8975 |
| Popis: | AuraGainTM, a novel third-generation laryngeal mask, can facilitate insertion of a gastric tube and provide the potential advantage of intubation. Data are lacking on intubation through the AuraGain laryngeal mask. Eighty-eight hip or knee surgery patients were enrolled in this parallel randomized-controlled trial. We hypothesized that intubation time using the AuraGain laryngeal mask would be no longer than that for standard flexible bronchoscopic intubation over a slit Guedel tube, with a non-inferiority margin of five seconds. The following data were recorded during a maximum of three intubation attempts: intubation time, number of intubation attempts, degree of resistance to advance the endotracheal tube, and mask placement (i.e., Brimacombe score). Follow-up outcomes, including neck pain, hoarseness, and dysphagia, were also measured two and 24 hr postoperatively. Patients and outcome assessors remained blinded until the last examination. Mean intubation time was similar between the Guedel tube and AuraGain groups (23.6 sec vs 21.4 sec, respectively). The upper limit of the 95% confidence interval (CI) of the difference in mean intubation time between groups fell below our pre-specified non-inferiority margin; therefore, we found the AuraGain laryngeal mask to be non-inferior to the slit Guedel tube (adjusted group difference, −1.6 sec; 95% CI, −3.7 to 0.5). Successful intubation was achieved in the majority of patients (≥ 95%) in each group on the first attempt. No resistance to insertion of the endotracheal tube was encountered in the majority of patients in each group, and no complications were reported during the 24-hr postoperative period. There was no difference in the Brimacombe score or in the status of postoperative morbidity between the two groups. We conclude that flexible bronchoscopic intubation through an AuraGain laryngeal mask can be achieved at least as fast as standard bronchoscopic intubation without contributing to additional patient morbidity or postoperative discomfort. www.clinicaltrials.gov , NCT 02570269. Registered 23 September 2015. |
| Databáze: | OpenAIRE |
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