Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard

Abstract

Purpose This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT). Methods In this prospective randomized study 68 patients American Society of Anesthesiologists (ASA) physical status I and II were included. Patients with criteria indicating possible difficult intubation were excluded. The patients were randomized into two groups, depending on the tool used to facilitate intubation: videolaryngoscope (VL group) or direct laryngoscopy (DL group). The time required for intubation was the primary endpoint. Cormack and Lehane glottic visualization (CL) scores, the need for external laryngeal maneuvers and the number of attempts were measured. Results Glottic visualization was better in the VL group than in the DL group. The CL scores were I, II and III in 24, eight and two patients, respectively, in the VL group compared with 13, 11 and eight in the DL group (P = 0.025). Patients in the VL group required fewer attempts than the DL group (P = 0.019). Intubation time was 39.9 ± 4.4 sec in the VL group and 47.9 ± 5.4 sec in the DL group (P \ 0.001). No intubation failure was noted in group VL compared with two in the DL group (not significant). Conclusion The use of a videolaryngoscope reduces the time required for intubation with a DLT compared with the direct laryngoscopy in elective thoracic surgery.

Prospective, randomised, controlled study comparing Videolaryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Tube Intubation in thoracic surgery

“…In regard to the incidence of dental trauma, a study by comparing DL and VL showed that less force is exerted on the teeth of the upper jaw when using VL (23,24). This is in accordance with the results of the current study situation (6,17). Our dental follow up showed no significant differences in DLT intubation-related injuries.…”

“…In (8). Considering only the four studies using GlideScope® videolaryngoscopy of that meta-analysis, our results are consistent with three of these four studies (6,7,16,17). Only Hsu et al were able to show shorter intubation times with Glidescope videolaryngoscopy for DLT intubation.…”

“…Prolonged intubation times for GVL videolaryngoscopy for DLT intubation were shown in previous studies (6,16,17). Prolonged intubation times inevitably have a greater risk of hypoxia and could be harmful to patients with pulmonary comorbidities.…”

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review

“…Eight studies reported on hypoxia, 23 27-29 50 55 71 79 and only three of these had event data. [27][28][29] Analysis showed no difference in hypoxia according to type of device (OR, randomeffects 0.39, 95% CI 0.10 to 1.44; I 2 ¼70%; n¼1319) (Supplementary Appendix S3).…”

“…38 41 42 78 81 Five studies used both novice and experienced anaesthetists. 28 48 54 68 84 Seven studies did not specify the experience of anaesthetists. 36…”