Pre-formed endotracheal tube and stepwise insertion for more successful intubation with video laryngoscopy

作     者：Ahmed A Shorrab Moustafa A Helal 

作者机构：Department of AnesthesiaUniversity Hospital SharjahSharjah POB 72772United Arab Emirates Faculty of MedicineMansoura UniversityMansoura 35516Egypt University Hospital SharjahSharjahUnited Arab Emirates 

出 版 物：《World Journal of Anesthesiology》 (世界麻醉学杂志)

年 卷 期：2021年第10卷第2期

页      面：7-15页

学科分类：1002[医学-临床医学] 100213[医学-耳鼻咽喉科学] 10[医学] 

基　　金：the Ethics and Research Committee of University Hospital Sharjah No.UHS-HERC-014-30072019 

主　　题：Intubation Glottis view Airway Indirect laryngoscopy Torque 

摘      要：BACKGROUND In anesthesia practice,orotracheal intubation remains the primary concern of the *** introduction of video laryngoscopy(VL)has increased the success rate of orotracheal intubation;however,conflicting results have been reported regarding the usefulness of the current technique with VL in clinical *** To describe a modification to improve intubation with VL,followed by evaluation of the practice in *** First,a mannequin trial was conducted with operators having different experience and ***,a retrospective analysis was performed for an1-year period with patients who underwent general anesthesia with orotracheal *** endotracheal tube used had been pre-formed with two *** intubation had been performed with direct eye vision,followed by screen assistance and rotation of the tube as needed to direct it toward the *** the mannequin trial,the outcome measures were quantification of torque(force with angular acceleration during levering),need for external maneuvers,and time to *** the clinical experience,orotracheal intubation used VL(pre-formed tube)or direct laryngoscopy(DL)at the anesthetist’s discretion and throat discomfort was reported by the *** In the mannequin trials using VL,there was less torque with the pre-formed tube than with a regular tube(8%and 65%,respectively).The first-pass rate was higher with the pre-formed tube(95%)than with a regular tube(81%).However,the time to intubate was longer with the pre-formed tube than with a regular tube(22 s and 12 s,respectively).In clinical practice,562 patients underwent surgery under general anesthesia with orotracheal intubation using either VL(n=244)or DL(n=318)at the discretion of the attending *** was specifically planned in 62 of the patients,due to anticipated *** attempts by readjustment of the curve of the tube were significantly fewer with VL than with DL(10%vs 18%).Throat discom