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01-08-2009 | Research Article

Video-Assisted Versus Conventional Tracheal Intubation in Morbidly Obese Patients

Authors: Gilles Dhonneur, Widad Abdi, Serge K. Ndoko, Roland Amathieu, Nabil Risk, Lodfi El Housseini, Claude Polliand, Gerard Champault, Xavier Combes, Loïc Tual

Published in: Obesity Surgery | Issue 8/2009

Abstract

Background

We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese patients whose trachea was intubated under video assistance with the LMA CTrach™ (SEBAC, Pantin, France) or the Airtraq™ laryngoscope (VYGON, Écouen, France) with that of the conventional Macintosh laryngoscope.

Methods

After standardized induction of anesthesia, 318 morbidly obese patients scheduled for elective morbid obesity surgery received tracheal intubation with the LMA CTrach™, the Airtraq™ laryngoscope, or the conventional Macintosh laryngoscope. Duration of apnea, time to tracheal intubation, and oxygenation quality during airway management were compared between the LMA CTrach™ and the laryngoscope groups.

Results

Patients’ characteristics were similar in the three groups. The success rate for tracheal intubation was 100% with the LMA CTrach™ and the Airtraq™ laryngoscope. One patient of the Macintosh laryngoscope group received LMA CTrach™ intubation because of early arterial oxygen desaturation associated with unstable facemask ventilation. The duration of apnea was shorter with the LMA CTrach™ than that of the Airtraq™ laryngoscope and the Macintosh laryngoscope. The duration tracheal intubation was shorter with the Airtraq™ laryngoscope than with the Macintosh laryngoscopes and the LMA CTrach™. During airway management, arterial oxygenation was of better quality with the LMA CTrach™ and the Airtraq™ laryngoscope than that of the Macintosh laryngoscope.

Conclusion

Because LMA CTrach™ promoted short apnea time and the Airtraq™ laryngoscope allowed early definitive airway, both video-assisted tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation of morbidly obese patients with the conventional Macintosh laryngoscope.

Dhonneur G, Ndoko SK, Yavchitz A, et al. Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy. Br J Anaesth. 2006;97:742–5.CrossRef

Dhonneur G, Ndoko S, Amathieu R, et al. Intubation using the Airtraq® in Morbid Obese Patients Undergoing Emergency Cesarean Delivery. Anesthesiology 2007;106:629–30.CrossRef

Dhonneur G, Ndoko S-K, Amathieu R, et al. A comparison of two techniques for inserting the Airtraq™ laryngoscope in morbidly obese patients. Anaesthesia 2007;62:774–7.CrossRef

Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth. 2008;100:263–8.CrossRef

Levitan RM, Ochroch EA, Kush S, et al. Assessment of airway visualization: validation of the percentage of glottic opening (POGO) scale. Acad Emerg Med. 1998;5:919–23.CrossRef

Adnet F, Borron SW, Racine SX, et al. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology 1997;87:1290–7.CrossRef

Goldman A, Rosenblatt W. The LMA CTrach™ in airway resuscitation: six case reports. Anaesthesia 2006;61:975–7.CrossRef

Goldman A, Rosenblatt W. Use of the fiberoptic intubating LMA CTrach™ in two patients with difficult airways. Anaesthesia 2006;61:601–3.CrossRef

Maharaj CH, Higgins BD, Harte BH, et al. Evaluation of intubation using the Airtraq® or Macintosh laryngoscope by anaesthesiologists in easy and simulated difficult laryngoscopy—a manikin study. Anaesthesia 2006;61:1093–9.CrossRef

10.

Maharaj CH, Buckley E, Harte BH, et al. Endotracheal intubation in patients with cervical spine immobilization: a comparison of Macintosh and Airtraq laryngoscopes. Anesthesiology 2007;107:53–9.CrossRef

11.

Maharaj CH, Costello JF, McDonnell JG, et al. The Airtraq as a rescue airway device following failed direct laryngoscopy: a case series. Anaesthesia 2007;62:598–601.CrossRef

12.

Norman A, Date A. Use of the Airtraq laryngoscope for anticipated difficult laryngoscopy. Anaesthesia 2007;62:533–4.CrossRef

13.

Combes X, Le Roux B, Suen P, et al. Unanticipated difficult airway in anesthetized patients: prospective validation of a management algorithm. Anesthesiology 2004;100:1146–50.CrossRef

Title: Video-Assisted Versus Conventional Tracheal Intubation in Morbidly Obese Patients
Authors: Gilles Dhonneur
Widad Abdi
Serge K. Ndoko
Roland Amathieu
Nabil Risk
Lodfi El Housseini
Claude Polliand
Gerard Champault
Xavier Combes
Loïc Tual
Publication date: 01-08-2009
Publisher: Springer New York
Published in: Obesity Surgery / Issue 8/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-008-9719-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Video-Assisted Versus Conventional Tracheal Intubation in Morbidly Obese Patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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