Video-Assisted Versus Conventional Tracheal Intubation in Morbidly Obese Patients

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• 作者：Gilles Dhonneur (1) (3) (4)
  Widad Abdi (1) (3)
  Serge K. Ndoko (1) (3)
  Roland Amathieu (1) (3)
  Nabil Risk (2) (3)
  Lodfi El Housseini (1) (3)
  Claude Polliand (2) (3)
  Gerard Champault (2) (3)
  Xavier Combes (1) (3)
  Lo?c Tual (1) (3)
  
• 关键词：Anesthesia induction ; Ventilation ; Tracheal intubation ; Oxygenation ; Morbid obesity
• 刊名：Obesity Surgery
• 出版年：2009
• 出版时间：August 2009
• 年：2009
• 卷：19
• 期：8
• 页码：1096-1101
• 全文大小：122KB
• 参考文献：1. Dhonneur G, Ndoko SK, Yavchitz A, et al. Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy. Br J Anaesth. 2006;97:742-. CrossRef
  2. Dhonneur G, Ndoko S, Amathieu R, et al. Intubation using the Airtraq? in Morbid Obese Patients Undergoing Emergency Cesarean Delivery. Anesthesiology 2007;106:629-0. CrossRef
  3. Dhonneur G, Ndoko S-K, Amathieu R, et al. A comparison of two techniques for inserting the Airtraq?laryngoscope in morbidly obese patients. Anaesthesia 2007;62:774-. CrossRef
  4. Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth. 2008;100:263-. CrossRef
  5. Levitan RM, Ochroch EA, Kush S, et al. Assessment of airway visualization: validation of the percentage of glottic opening (POGO) scale. Acad Emerg Med. 1998;5:919-3. CrossRef
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  9. Maharaj CH, Higgins BD, Harte BH, et al. Evaluation of intubation using the Airtraq? or Macintosh laryngoscope by anaesthesiologists in easy and simulated difficult laryngoscopy—a manikin study. Anaesthesia 2006;61:1093-. CrossRef
  10. Maharaj CH, Buckley E, Harte BH, et al. Endotracheal intubation in patients with cervical spine immobilization: a comparison of Macintosh and Airtraq laryngoscopes. Anesthesiology 2007;107:53-. CrossRef
  11. Maharaj CH, Costello JF, McDonnell JG, et al. The Airtraq as a rescue airway device following failed direct laryngoscopy: a case series. Anaesthesia 2007;62:598-01. CrossRef
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  13. Combes X, Le Roux B, Suen P, et al. Unanticipated difficult airway in anesthetized patients: prospective validation of a management algorithm. Anesthesiology 2004;100:1146-0. CrossRef
  
• 作者单位：Gilles Dhonneur (1) (3) (4)
  Widad Abdi (1) (3)
  Serge K. Ndoko (1) (3)
  Roland Amathieu (1) (3)
  Nabil Risk (2) (3)
  Lodfi El Housseini (1) (3)
  Claude Polliand (2) (3)
  Gerard Champault (2) (3)
  Xavier Combes (1) (3)
  Lo?c Tual (1) (3)
  
  1. Anesthesiology and Intensive Care Medicine Department, Jean Verdier Public University Hospital of Paris (APHP), 93143, Bondy, France
  3. Paris 13 School of Medicine, EA 3409, 93000, Bobigny, France
  4. Département d’Anesthésie et Réanimation, CHU (APHP) Jean Verdier, Av du 14 Juillet, 93143, Bondy, France
  2. Morbid Obesity and Visceral Surgery Department, Jean Verdier Public University Hospital of Paris (APHP), 93143, Bondy, France
  

文摘

Background We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese patients whose trachea was intubated under video assistance with the LMA CTrach?(SEBAC, Pantin, France) or the Airtraq?laryngoscope (VYGON, écouen, France) with that of the conventional Macintosh laryngoscope. Methods After standardized induction of anesthesia, 318 morbidly obese patients scheduled for elective morbid obesity surgery received tracheal intubation with the LMA CTrach? the Airtraq?laryngoscope, or the conventional Macintosh laryngoscope. Duration of apnea, time to tracheal intubation, and oxygenation quality during airway management were compared between the LMA CTrach?and the laryngoscope groups. Results Patients-characteristics were similar in the three groups. The success rate for tracheal intubation was 100% with the LMA CTrach?and the Airtraq?laryngoscope. One patient of the Macintosh laryngoscope group received LMA CTrach?intubation because of early arterial oxygen desaturation associated with unstable facemask ventilation. The duration of apnea was shorter with the LMA CTrach?than that of the Airtraq?laryngoscope and the Macintosh laryngoscope. The duration tracheal intubation was shorter with the Airtraq?laryngoscope than with the Macintosh laryngoscopes and the LMA CTrach? During airway management, arterial oxygenation was of better quality with the LMA CTrach?and the Airtraq?laryngoscope than that of the Macintosh laryngoscope. Conclusion Because LMA CTrach?promoted short apnea time and the Airtraq?laryngoscope allowed early definitive airway, both video-assisted tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation of morbidly obese patients with the conventional Macintosh laryngoscope.