A comparative study of effectiveness of video laryngoscopy and direct laryngoscopy in patients with at least three predictors of difficult intubation
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: Difficulty in achieving a patent airway depends mainly on anatomical factors which play a predominant role in deciding the degree of difficult airway. The identification of the patients with difficult airway is vital in the preoperative evaluation and planning anaesthesia management, so that endotracheal intubation and positive pressure ventilation can be achieved safely by alternative methods of tracheal intubation.Aim and objectives: To study and compare the effectiveness of video laryngoscopy and direct laryngoscopy in patients with at least three predictors of difficult intubationMaterials and method: The present hospital based prospective randomized control study was conducted with 200 patients with atleast three predictors of difficult intubation. The patients were randomly divided into following groups of 100 patients each. Group D: Patients intubated with direct laryngoscope Group V: Patients intubated with video laryngoscope. Patients between the age group of 20-50years of age posted for various surgical procedures under general anaesthesia with ASA grade I or II and with atleast three 3 predictors of difficult intubation were included in the study. Results: It was found that there was no statistically significant difference between the patients in both groups in terms of age, sex, BMI, ASA class, Mallampati classification III or IV , the mean interincisor gap , thyromental distance and the presence of buck teeth. In group D airway was secured in first attempt in 82% patients while it was 94% in group V. Video laryngoscopy provided a significantly better view of the laryngeal structures than direct laryngoscopy as per Chi-Square test. The use of external laryngeal manipulation/facilitation with a bougie was significantly more in Group D as compared to Group V (37% vs. 24%). The mean laryngoscopy time was significantly higher in Group D as compared to Group V (42.33 ± 1.76 secs vs. 33.16 ± 2.08 secs). In Group D, 25% patients had sore throat while 10% and 3% patients had Lip/gum/oral trauma and Oxygen desaturation <90% respectively. In Group V, 28% patients had sore throat while 6% and 4% patients had Lip/gum/oral trauma and Oxygen desaturation<90% respectively.Conclusion: Thus with reference to above mentioned results and discussion we conclude that Video laryngoscope eases tracheal intubations in patients with expected difficult intubations. The view of the laryngeal entrance is significantly improved, with a decreased number of optimizing manoeuvres and in less time. Overall, these improvements of the conditions for tracheal intubations result in a significantly higher success rate of trachael intubations.
Authors and Affiliations
Nikita Budhiwant, Aparna Kulkarni
Keywords
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- EP ID EP616666
- DOI 10.26611/101510215
- Views 175
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