Comparative Study of Orotracheal Intubation through Air Q Laryngeal Mask Airway: Blind Versus Fiberoptic Guided During General Anesthesia

This study was designed to compare the hemodynamic and arousal responses to blind orotracheal intubation through Air Q laryngeal mask airway versus flexible fiberoptic guided. 100 adult patients ASA I and II undergoing elective surgeries under general anesthesia with orotracheal intubation were divided into two groups according to the technique of intubation through Air-Q ILA Group І (n= 50) patients intubated blindly through Air-Q ILA Group ІІ (n=50) patients intubated through Air-Q ILA guided by flexible fiberoptic bronchoscope. The following parameters were recorded: heart rate, systolic, diastolic and mean arterial blood pressure and Bispectral Index (BIS) values: preinduction, after induction of anesthesia, then at 1 and 5 minutes after intubation, arterial oxygen saturation (SpO2): before, during and after intubation, time of insertion(in seconds) and number of attempts of insertion of the endotracheal tube and airway complications; injury to the gums or teeth damage, hoarseness of the voice, bleeding, sore throat. Systolic and mean arterial blood pressures were statistically significant lower in the fiberoptic group than the blind group. There was no statistically significant difference between the two groups in the heart rate and diastolic blood pressure.There was statistically significant lower time of intubation and less number of attempts in fiberoptic group than in blind group, the success rate of intubation in the fiberoptic group was 100% compared to 76% in blind group. There was statistically significant lower BIS value in the fiberoptic group 1 minute after intubation than in the blind group. Endotracheal intubation through the Air-Q ILA guided by flexible fiberoptic bronchoscope is associated with less hemodynamic and arousal responses than blind endotracheal intubation through the Air-Q ILA, the number of attempt and time of successful intubation were statistically significantly lower in the fiberoptic group than the blind group

___

1. Caplan RA, Posner KL, Ward RJ, Cheney FW. Adverse respiratory events in anesthesia, a closed claims analysis. Anesthesiology. 1990;72(5):828-33.

2. Brain AIJ. Three cases of difficult intubation overcome by the laryngeal mask airway. Anaesthesia. 1985;40(4):353-5.

3. Parmet JL, Colonna-Romano P, Horrow JC, Miller F, Gonzales J, Rosenberg H. The laryngeal mask airway reliably provides rescue ventilation in cases of unanticipated difficult tracheal intubation along with difficult mask ventilation. Anesth Analg. 1998;87(3):661-5.

4. Hagberg CA, Jensen FS, Genzwuerker HV, Krivosic-Horber R, Schmitz BU, Hinkelbein J, Contzen M, Menu H, Bourzoufi K. A multicenter study of the Ambu laryngeal mask in nonparalyzed anesthetized patients. Anesth Analg. 2005;101(6):1862-6.

5. Brain AIJ, Verghese C, Addy EV, Kapila A, Brimacombe J. The intubating laryngeal mask, a preliminary clinical report of a new means of intubating the trachea. Br J Anaesth. 1997;79(6):704-9.

6. Jagannathan N, Roth AG, Sohn LE, Pak TY, Amin S, Suresh S. The new air Q intubating laryngeal airway for tracheal intubation in children with anticipated difficult airway: a case series. Paediatr Anaesth. 2009;19(6):618-22.

7. Imai M, Matsumura C, Hanaoka Y, Kemmotsu O. Comparison of cardiovascular responses to airway management: fiberoptic intubation using a new adapter, laryngeal mask insertion, or conventional laryngoscopic intubation. J Clin Anesth. 1995;7(1):14-8.

8. Takahashi SJ, Mizutani T, Miyabe M, Toyooka H. Hemodynamic responses to tracheal intubation with laryngoscope versus lightwand intubating device (Trachlight) in adults with normal airway. Anesth Analg. 2002;95(2):480-4.

9. Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth. 1987;59(3):295-9.

10. Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology. 1998;88(3):642-50.

11. Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS. Anesthesia awareness and the bispectral index. N Engl J Med. 2008;358(11):1097-108

12. el-Ganzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD. Preoperative airway assessment, predictive value of a multivariate risk index. Anesth Analg. 1996;82(6):1197-204.

13. Kanazawa M, Nitta M, Murata T, Suzuki T. Increased dosage of propofol in anesthesia induction cannot control the patient’s responses to insertion of a laryngeal mask airway. Tokai J Exp Clin Med. 2006;31(1):35-8.

14. El-Ganzouri AR, Marzouk S, Abdelalem N, Yousef M. Blind versus fiberoptic laryngoscopic intubation through air Q laryngeal mask airway. Egypt J Anesth. 2011;27(4):213-8.

15. Karim YM, Swanson DE. Comparison of blind tracheal intubation through the intubating laryngeal mask airway (LMA Fastrach TM) and the Air-QTM. Anaesthesia. 2011;66(3):185-90.

16. Bashandy GMN, Boules NS. Air-Q the Intubating laryngeal Airway: comparative study of hemodynamic stress responses to tracheal intubation via air-Q and direct laryngoscopy. Egypt J Anesth. 2012;28(2):95-100.

17. Zhang GH, Xue FS, Sun HY, Li CW, Sun HT, Li P, Liu KP. Comparative study of hemodynamic responses to orotracheal intubation with intubating laryngeal mask airway. Chin Med J (Engl). 2006;119(11):899-904.

18. Abdel-Halim TM, Abo El Enin MA, Elgoushi MM, Afifi MG, Atwa HS. Comparative study between Air-Q and Intubating Laryngeal Mask Airway when used as conduit for fiber-optic. Egypt J Anaesth. 2014;30(2):107-13.

19. Badawi R, Mohamed NN, Al-Haq MMA. Tips and tricks to increase the success rate of blind tracheal intubation through the Air-Q versus the intubating laryngeal mask airway Fastrach. Egypt J Anaesth. 2014;30(1):59-65.

20. El-Ganzouri AR, Marzouk S, Youssef MMI, Abdelalem N. The use of AIR-Q as conduit for fiberoptic endotracheal intubation in adult paralyzed patients. Egypt J Anaesth. 2012;28(4):249-55.

21. Bakker EJ, Valkenburg M, Galvin EM. Pilot study of the air-Q intubating laryngeal airway in clinical use. Anaesth Intens Care. 2010;38(2):346-8.

22. Pandit JJ, MacLachlan K, Dravid RM, Popat MT. Comparison of times to achieve tracheal intubation with three techniques using the laryngeal or intubating laryngeal mask airway. Anaesthesia. 2002;57(2):128-32.

23. El-Ganzouri AR, Marzouk S, Abdelalem N, Yousef M. Blind vs fiberoptic laryngoscopic intubation through Air-Q laryngeal mask airway. Egypt J Anesthesia. 2010;27(4):213-8.

24. Versichelen L, Struys M, Crombez E, Fonck K, Mortier E, Rolly G. Haemodynamic and electroencephalographic response to insertion of a cuffed oropharyngeal airway: comparison with the laryngeal mask airway. Br J Anaesth. 1998;81(3):393-7.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Useage of Intra-aortic Baloon Pump in the Open Heart Surgeries

Ozden Gulal OZDEMİR, Ali Ümit YENER, Mustafa SAÇAR

Effectiveness of Natural Killer (NK) Cells in Peripheral Blood Stem-Cell towards Expression of EZH2, Ki-67 and Apoptosis in Retinoblastoma (RB) Cells Culture

Hendrian D. SOEBAGJO, Susy FATMARİYANTİ, Delfitri LUTFİ

Communication Skills, Empathic Tendency and Affecting Factors of Assistant Doctors in Inonu Universty, Faculty of Medicine, Malatya

Çiğdem BOZKIR, Çiğdem TEKİN, Burak METE, Erkay NACAR, Ali ÖZER

Exploring the Utility of Social Marketing Techniques in Motivating People to Adopt Healthy Behavior

Saurabh RamBihariLal SHRIVASTAVA, Prateek Saurabh SHRİVASTAVA, Jegadeesh RAMASAMY

A Compulsive Avoidance Behavior: Blocked Ejaculation

ALPER EVRENSEL, Orcun AYKOL, Gökçe CÖMERT

Moxifloxacin Induced Acute Delirium with Visual Hallucinations

Ergenekon KARAGÖZ, Asım ÜLÇAY, Asil BUDAKLİ, Recep TÜTÜNCÜ

Thyroid Gland Hemiagenesis with Multinodular Graves' Disease: A Case Report

Dilek BERKER, Gulhan AKBABA, Ayse ARDUC, Mazhar Muslum TUNA, Bercem AYCİCEK DOGAN, Serdar GULER

Pre-opereative Parathormone Levels are Correlated with Mean Diameter of Parathyroid Adenoma and Pre-operatıve Serum Calcium and Alkaline Phosphatase Levels

Gülşah ELBÜKEN, Recep AKTİMUR, Kadir YILDIRIM, Sude Hatun AKTİMUR, MEHMET DERYA DEMİRAĞ, Aysu Başak ÖZBALCI, Mustafa BAKIRTAŞ, Banu KİRTİLOGLU, NURAYDIN ÖZLEM

A Viral Outcome

Cyriac Abby PHİLİPS

Investigation of Extended-Spectrum Beta-Lactamase (Esbl) in Nosocomial Gram-Negative Bacterial Isolates by Different Test Methods

FİLİZ ORAK, Akgün YAMAN, Gülşah ŞEYDAOĞLU