Amr Samir Wahdan

Citation:

Wahdan, A. S., N. A. R. Elrefai, S. H. Omar, S. A. Abdel Moneem, M. M. Mohamed, and M. M. Hussien, "Endotracheal intubation in patients undergoing open abdominal surgery in the lateral position: a comparison between intubating video stylet and fiberoptic intubating bronchoscopy.", Korean journal of anesthesiology, 2021.

Abstract:

Background: We compared elective endotracheal intubation in lateral decubitus position using a video stylet device with fiberoptic bronchoscope device in patients undergoing laparotomy abdominal surgery.

Methods: Overall, 50 patients were enrolled in this prospective, randomised study. They were randomly classified into either video stylet (VS) intubation group or fiberoptic (FO) intubating bronchoscope group. After anaesthesia induction, patients were placed in lateral decubitus position, and a single investigator well versed in the use of the VS and FO bronchoscope performed the intubation. The primary outcome was the time taken for intubation. Secondary outcomes included intubation success rate, hemodynamic response at specific time points, overall user satisfaction and perioperative complications.

Results: The average time taken for intubation was significantly lower in the VS group than that in the FO group, with values of 39.5 ± 10 and 75.6 ± 16.2 s, respectively (P < 0.001). Incidence of successful first attempt intubation in the VS group was 88% vs. 100% in the FO group, which was statistically not different. There was a negligible difference in complications between the groups except sore throat, which showed a higher incidence in the VS group than that in the FO group (P = 0.013).

Conclusions: In laterally positioned patients, elective endotracheal intubation with VS provides less intubation time and incidence of success rate for a single intubation trial [88%]; however, its use is accompanied by a significant increase in hemodynamic response after intubation and an increased incidence of sore throat.