دورية
Channelled versusnonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial
العنوان: | Channelled versusnonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial |
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المؤلفون: | Shin, Kyung Won, Lee, Sang Phil, Kim, Taeyup, Choi, Seungeun, Kim, Yoon Jung, Park, Hee-Pyoung, Oh, Hyongmin |
المصدر: | Canadian Journal of Anesthesia; 20240101, Issue: Preprints p1-11, 11p |
مستخلص: | Purpose: Channelled blades have the advantage of avoiding stylet use and potential airway injury during videolaryngoscopic intubation. Nevertheless, the effectiveness of channelled Macintosh-type blades has not yet been fully established. We sought to assess the utility of channelled Macintosh-type blades for videolaryngoscopic intubation under cervical spine immobilization. Methods: We conducted a randomized controlled noninferiority trial in neurosurgical patients with a difficult airway simulated by a cervical collar. Videolaryngoscopic intubation with a reinforced tracheal tube was performed using a channelled Macintosh-type blade without a stylet (channelled group, n= 130) or a nonchannelled Macintosh-type blade with a stylet (nonchannelled group, n= 131). The primary outcome was intubation success rate. Secondary outcomes included time to intubation and incidence or severity of intubation-related complications (subglottic, lingual, and dental injuries; bleeding; sore throat; and hoarseness). Results: The initial intubation success rate was 98% and 99% in the channelled and nonchannelled groups, respectively, showing the noninferiority of the channelled group (difference in proportions −0.8%; 95% confidence interval [CI], −4.8% to 2.9%; predefined noninferiority margin, −5%; P= 0.62). Fewer participants in the channelled group had subglottic injuries than in the nonchannelled group (32% [32/100] vs57% [54/95]; difference in proportions, −25%; 95% CI, −39% to −11%; P< 0.001). There were no significant differences between the two groups in the overall intubation success rate, time to intubation, and incidence or severity of other intubation-related complications. Conclusions: For videolaryngoscopic intubation in patients with a cervical collar, channelled Macintosh-type blades are an alternative to nonchannelled Macintosh-type blades, with a noninferior initial intubation success rate and a lower incidence of subglottic injury. Study registration: CRIS.nih.go.kr ( |
قاعدة البيانات: | Supplemental Index |
تدمد: | 0832610X 14968975 |
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DOI: | 10.1007/s12630-024-02769-3 |