Comparison of haemodynamic responses to intubation: Flexible fibreoptic bronchoscope versus bonfils rigid intubation endoscope

Gupta, Kapil; Girdhar, Kiran Kumar; Anand, Raktima; Majgi, Sumanth Mallikarjuna; Gupta, Surinder Pal; Gupta, Payal

doi:10.4103/0019-5049.100816

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Some authors compared fiberoptic intubation with the use of Bonfils optical stylets. They concluded that both devices require a similar time for successful orotracheal intubation and cause a similar magnitude of hemodynamic response [27]. As evidenced in our study, the response to intubation using the Levitan FPS device was greater than that of the Lary-Flex videolaryngoscope.…”

Section: Discussionsupporting

confidence: 68%

A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

Gaszyński

Pietrzyk²,

Szewczyk

et al. 2014

The Scientific World Journal

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Introduction. The use of videolaryngoscopes is recommended for morbidly obese patients. The aim of the study was to evaluate the Levitan FPS optical stylet (Levitan) vs Lafy-Flex videolaryngoscope (Lary-Flex) in a group of MO patients. Methods. Seventy-nine MO (BMI > 40 kg m−2) patients scheduled for bariatric surgery were included in the study and randomly allocated to the Levitan FPS or Lary-Flex group. The primary endpoint was time to intubation and evaluation laryngoscopic of glottic view. Anesthesiologists were asked to evaluate the glottic view first under direct laryngoscopy using the videolaryngoscope as a standard laryngoscope (monitor display was excluded from use) and then using devices. The secondary endpoint was the cardiovascular response to intubation and the participant's evaluation of such devices. Results. The time to intubation was 8.572.66 sec. versus 5.790.2 sec. for Levitan and Lary-Flex, respectively (P < 0.05). In all cases of CL grade >1 under direct laryngoscopy, the study devices improved CL grade to 1. The Levitan FPS produced a greater cardiovascular response than the Lary-Flex videolaryngoscope. Conclusion. The Lary-Flex videolaryngoscope and the Levitan FPS optical stylet improve the laryngeal visualization in morbidly obese patients, allowing for fast endotracheal intubation, but Lary-Flex produces less cardiovascular response to intubation attempt.

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Section: Discussionsupporting

confidence: 68%

A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

Gaszyński

Pietrzyk²,

Szewczyk

et al. 2014

The Scientific World Journal

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“…In our study, we used the retromolar technique. Compared to the midline approach, the retromolar limits the manipulation of the epiglottis and the posterior aspect of the tongue, which are richly innervated in adrenergic receptors [ 14 ]. By having a better visualization of the epiglottis we hypothesized that there is a reduction in the sympathetic stimulation leading to tachycardia.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial

2018

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BackgroundDirect laryngoscopy (DL) produce tachycardia and hypertension that could be fatal in a patient with a brain injury. Bonfils fiberscope and C-MAC videolaryngoscope are associated with little hemodynamic instability compared to DL. Scientific evidence comparing these two alternatives does not exist. We conducted this study to determine the hemodynamic effects of Bonfils compared to C-MAC in patients undergoing elective surgery.MethodsFifty (50) patients listed for elective surgery were randomly assigned to endotracheal intubation with Bonfils or C-MAC. After a standardized induction, intubation was done via the retromolar approach (Bonfils group) or via videolaryngoscopy (C-MAC group). A research assistant, who was not blinded to the intervention, recorded heart rate (HR) and arterial blood pressure (systolic, diastolic and mean arterial blood pressure [MAP]) at induction and at every minute during the 5 min post intubation. The primary outcome was the hemodynamic response to intubation, as verified every minute for the first 5 min compared to baseline value.ResultsAfter randomization, the two groups were comparable except for ASA I/II ratio which was slightly higher in the C-MAC group (p = 0.046). Heart rate (p = 0.40) and MAP (p = 0.30) were comparable between the two groups within 5 min post intubation. Intubation time was shorter with C-MAC than with Bonfils (30 ± 2 s vs 38 ± 2 s; p = 0.02).ConclusionHemodynamic responses to tracheal intubation using the Bonfils fiberscope is comparable to the C-MAC videolaryngoscope among patients scheduled for an elective surgery. In light of these findings, using either technique appears to be a reasonable course of action.Trial registrationISRCTN #34923, retrospectively registered, 26/03/2018.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0592-7) contains supplementary material, which is available to authorized users.

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“…These authors also concluded that there was no significant difference in HR and BP at any of the measuring points or in their maximum values during observation between their two groups. [13]…”

Section: Discussionmentioning

confidence: 99%

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy

Chalam

Gupta

2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy.Material and Methods:Sixty patients of age group 20–60 years, of American Society of Anesthesiologists status I or II, were enrolled in this prospective and randomized study. They were allocated to one of the two groups, ILMA group and FOB group. The patients were intubated orally using either equipment, after dexmedetomidine premedication and induction of general anesthesia. Chi-square and Fisher exact tests were used to find the significance of study parameters on a categorical scale. Paired samples t-test and Student's t-test were used to find the significance of study parameters on a continuous scale. Significance was assessed at 5% level of significance.Results:Bronchoscopy was a faster method of securing airway as compared with ILMA (38.13 ± 11.52 vs. 29.83 ± 13.75 s). Tracheal intubation was successful in all 60 patients (100%), belonging to both groups.Conclusion:ILMA and FOB were comparable with regards to ease of intubation in terms of time, the number of attempts and hemodynamic stability.

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Comparison of haemodynamic responses to intubation: Flexible fibreoptic bronchoscope versus bonfils rigid intubation endoscope

Cited by 11 publications

References 26 publications

A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy

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