Comparison of Nasal Intubations by GlideScope With and Without a Bougie Guide in Patients Who Underwent Maxillofacial Surgeries: Randomized Clinical Trial

Pourfakhr, Pejman; Ahangari, Ailar; Etezadi, Farhad; Moharari, Reza Shariat; Ahmadi, Ayat; Saeedi, Negin; Najafi, Atabak

doi:10.1213/ane.0000000000002853

Cited by 11 publications

(9 citation statements)

References 20 publications

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“…We discarded case reports, articles on the pediatric population, manikin studies, and non-English language studies from the remaining 42 articles. Of the 19 articles selected for qualitative data synthesis, nine studies were excluded because of the type of study participants [ 16 , 17 ], non-RCT studies [ 18 , 19 ], use of only VL [ 20 – 23 ], and inadequate data [ 24 ]. For the systematic review and meta-analysis, a total of 10 studies (n = 597) were included ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oromaxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials

Gupta

Sarma

et al. 2021

Korean J Anesthesiol

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Background: Nasotracheal intubation (NTI) is commonly performed in oromaxillofacial surgeries. We did this metanalysis to ascertain whether use of video laryngoscopy (VL) provided better NTI characteristics as compared to direct laryngoscopy (DL) in patients undergoing oromaxillofacial surgeries.Methods: We performed a systematic search to identify randomized controlled trials comparing VL with DL for NTI in adults undergoing elective oromaxillofacial surgery. The primary outcome was time to intubation. Secondary outcomes included the first attempt success, overall success, incidence of nasal bleeding, Cormack and Lehane grade, and maneuvers required. Results: Of the 456 studies identified following a systematic search, 10 were included. Meta-analysis showed a significantly lower time to tracheal intubation favoring VL (mean difference: –9.04, 95% CI [–12.71, –5.36], P < 0.001; I2 = 59%). VL was also associated with a greater first attempt success (relative risk [RR]: 1.10, 95% CI [1.04, 1.16], P = 0.001). Maneuvers to facilitate intubation were less with VL (RR: 0.22, 95% CI [0.10, 0.51], P < 0.001). There was no difference in overall intubation success (RR: 1.04, 95% CI [0.98, 1.10], P = 0.17). The incidence of bleeding did not differ between the DL and VL groups (RR: 0.59, 95% CI [0.32, 1.08], P = 0.09).Conclusions: Evidence as per this meta-analysis suggests VL leads to a shorter time to NTI, a greater first attempt success rate, and reduced need for maneuvers when compared to DL. The present study supports use of VL as a first line device for NTI in oral-maxillofacial surgeries in experienced hands.

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Section: Resultsmentioning

confidence: 99%

Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oromaxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials

Gupta

Sarma

et al. 2021

Korean J Anesthesiol

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“…For nasotracheal intubation with hyperangulated videolaryngoscopes, stylets cannot be used; hence, maneuverability of the tube in the pharynx and advancement of the tube through the laryngeal inlet might be affected. In these cases, Magill forceps are typically used to improve tube advancement [42].…”

Section: Discussionmentioning

confidence: 99%

Glidescope Video Laryngoscopy in Patients with Severely Restricted Mouth Opening—A Pilot Study

Popal,

Dankert,

Hilz

et al. 2023

JCM

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Background: An inter-incisor gap <3 cm is considered critical for videolaryngoscopy. It is unknown if new generation GlideScope Spectrum™ videolaryngoscopes with low-profile hyperangulated blades might facilitate safe tracheal intubation in these patients. This prospective pilot study aims to evaluate feasibility and safety of GlideScopeTM videolaryngoscopes in severely restricted mouth opening. Methods: Feasibility study in 30 adults with inter-incisor gaps between 1.0 and 3.0 cm scheduled for ENT or maxillofacial surgery. Individuals at risk for aspiration or rapid desaturation were excluded. Results: The mean mouth opening was 2.2 ± 0.5 cm (range 1.1–3.0 cm). First attempt success rate was 90% and overall success was 100%. A glottis view grade 1 or 2a was achieved in all patients. Nasotracheal intubation was particularly difficult if Magill forceps were required (n = 4). Intubation time differed between orotracheal (n = 9; 33 (25; 39) s) and nasotracheal (n = 21; 55 (38; 94) s); p = 0.049 intubations. The airway operator’s subjective ratings on visual analogue scales (0–100) revealed that tube placement was more difficult in individuals with an inter-incisor gap <2.0 cm (n = 10; 35 (29; 54)) versus ≥2.0 cm (n = 20; 20 (10; 30)), p = 0.007, while quality of glottis exposure did not differ. Conclusions: GlidescopeTM videolaryngoscopy is feasible and safe in patients with severely restricted mouth opening if given limitations are respected.

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“…In clinical applications, the tip of the nasotracheal tube will course posteriorly into the oesophagus in most cases. Magill forceps have been frequently used to complete the NTI process in several previous studies [1][2][3][4]. However, this instrument may cause rupture of the cuff or mucosal injury and even lead to infection [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial

Niu

et al. 2021

Preprint

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Background: Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps.Methods: Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision.Results: All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group.Conclusions: We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI.Trial registration: Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR1900027387). This trial was prospectively registered on 11 November 2019.

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Comparison of Nasal Intubations by GlideScope With and Without a Bougie Guide in Patients Who Underwent Maxillofacial Surgeries: Randomized Clinical Trial

Abstract: The GEB is a useful aid to nasotracheal intubation, reducing bleeding, the requirement for Magill forceps and, to a small degree, intubation time. A case exists for its routine use for this purpose.

Cited by 11 publications

References 20 publications

Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oromaxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials

Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oromaxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials

Glidescope Video Laryngoscopy in Patients with Severely Restricted Mouth Opening—A Pilot Study

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial

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