Anestesia e Pesquisa Clínica
Acesso livre
ISSN: 2155-6148
ISSN: 2155-6148
Palvannan Sivalingam, Gerard Ariotti and Catherine Jowett
Background: A ‘bougie’ may be less traumatic than the GlideScope-specific intubating stylet during videolaryngoscopy-guided intubation, but no comparative studies of bougies have been performed. Study objective: To compare the Portex tracheal tube introducer (PTTI) and Frova intubating introducer (FII) used with the GlideScope videolaryngoscope in simulated difficult intubation. Design: Randomised controlled study. Setting: A metropolitan tertiary referral and teaching hospital in Brisbane, Australia. The study was conducted from August 2011 to July 2013. Patients: Forty patients with American Society of Anaesthesiologists (ASA) grade 1 or 2 physical status who required tracheal intubation for elective surgery were randomly assigned to two equal groups. All completed the study. Those with known or suspected difficult intubation, cervical spine injury, raised intracranial pressure, risk of pulmonary aspiration, and risk of rapid oxygen desaturation were excluded. Interventions: After standardised intravenous induction, cervical manual in-line stabilisation was performed to increase intubation difficulty. Intubation was performed under GlideScope videolaryngoscopy assisted by either the PTTI or the FII. Measurements: The primary outcome measures were intubation time (s) and success rate (%). The secondary outcome measures were visual analogue scale (0-100 mm) and ordinal scale (1-4) scores of intubation difficulty. Main results: The median intubation times (interquartile ranges) in the PTTI and FII groups were 46 (35.3-68) and 55.8 (37.5-112.5) s, respectively (P>0.05). All intubations were successful in the PTTI group, but two intubations (10%) initially failed in the FII group (P>0.05). The median visual analogue scale score was significantly lower in the PTTI group (20 [10-40] vs. 40 [30-60]; P<0.01). The bougies did not cause any injury.