None listed
Conditions
Brief summary
Background:Tracheal intubation is the gold standard for securing the airway, laryngoscopy and endotracheal intubation induce pressor response which is of concern in patients with cardiac diseases and patients with cerebrovascular lesions, not only laryngoscopy and tracheal intubation cause cardiovascular responses but also induce an arousal response on the EEG .The AIR-Q intubating Laryngeal Mask (Air-Q ILA Cookgas LLC; distributed by Mercury Medical)is a new supraglottic device with the following advantages: ease of insertion, reliable alignment of the glottis opening, ability for continuous oxygenation and ventilation . Methods: This study was conducted at Beni- Suef University Hospital,Egypt, 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 I (n= 50)patients intubated blindly through Air-Q ILA Group II (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 Air-Q ILA and endotracheal tube and airway complications; injury to the gums or teeth damage, hoarseness of the voice , bleeding, sore throat. Results: Systolic and mean arterial blood pressures were statistically significant lower in the fiberoptic group than blind group. There was no statistically significant difference between the two groups in the heart rate and diastolic blood pressure. Time and number of attempts of insertion of Air-Q ILA were statistically significant lower in fiberoptic group than in blind group. There was statistically significant lower time of intubation and less number of attempts in fiberoptic group than in blind group and 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 Conclusion: endotracheal intubationthrough the Air-Q ILA guided by flexible fiberoptic bronchoscope is associated with less hemodynamic pressor response and arousal response 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
Interventions
This study was conducted at Beni- Suef University Hospital,Egypt. 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 I (n= 50) patients intubated blindly using air Q intubating laryngeal airway (Air-Q ILA): the cuff of the Air-Q ILA was deflated until two dimples appear at the back of Air-Q ILA as described by manufacturer and was lubricat
This study was conducted at Beni- Suef University Hospital,Egypt. 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 I (n= 50) patients intubated blindly using air Q intubating laryngeal airway (Air-Q ILA): the cuff of the Air-Q ILA was deflated until two dimples appear at the back of Air-Q ILA as described by manufacturer and was lubricated with xylocain gel 2% , the Air-Q ILA was inserted into the patients mouth with the upper incisor of the patient opposite the lower landmark on the tube of the air Q ILA to prevent epiglottic folding with the cuff of the Air-Q ILA, the cuff then inflated with 10-15 ml air and connected to the circle system.After confirmation of ventilation by capnography, bilateral chest expansion , and bilateral auscultation of breath sounds the air Q ILA mask adaptor was disconnected, a well lubricated PVC endotracheal tube (ID 7mm in females,7.5 in males)was advanced through its shaft blindly then connected to the circle system, successful endotracheal intubation and ventilation was confirmed with capnography, then the cuffs of the Air-Q ILA and endotracheal tube were deflated, the ETT connector was removed then the Air-Q ILA was removed over a special stylet, Then, the ETT connector was placed into its position ,the cuff reinflated and the ETT was connected to the circle system, any blood visible on the device indicative of trauma to the upper airway or bronchospasm were recorded If first attempt of intubation failed, the second attempt was done by maximal head extension and mandibular lift,If the second attempt failed, the third attempt was done by fiberoptic bronchooscope through Air-Q ILA.).
Sponsors
faculty of medicine benisuef university
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
ASA (I–II) planned for elective surgical operations under general anesthesia with oral endotracheal intubation.
Exclusion criteria
hypertension, neurological, cardiovascular, endocrine disease, risk of regurgitation and pulmonary aspiration, cervical spine lesion, patients undergoing cardiac and neurosurgical procedures, risk index of El-Ganzouri for difficult tracheal intubation more than or eqaul 4, BMI > 35 kg/m2, oropharyngeal mass, respiratory pathology, or any history of allergy to drugs used in the protocol
Outcome results
None listed