4 research outputs found
Postoperative sore throat and subglottic injury after McGrathÂŽ MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score: a randomized controlled trial
Background
A tracheal tube stylet can be used to assist successful tracheal intubation, especially during videolaryngoscopic intubation because videolaryngoscopes with a Macintosh-type blade such as McGrathÂŽ MAC videolaryngoscope have more acute angle than conventional Macintosh laryngoscope. However, the use of a stylet during tracheal intubation can raise concerns about stylet-induced postoperative airway complications, such as sore throat, subglottic injury, and hoarseness. In this study, we compared the incidence of postoperative airway complications after McGrathÂŽ MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score.
Methods
In 104 patients with Mallampati score III or IV and who were scheduled for lumbar or thoracic spine surgery, McGrathÂŽ MAC videolaryngoscopic intubation was performed either with a stylet (group S, nâ=â52) or without a stylet (group N, nâ=â52). The primary outcome measure was the incidences of sore throat evaluated at 1 and 24âh postoperatively. Secondary outcome measures were the incidences of subglottic injury and postoperative hoarseness.
Results
The incidence of CL grade III in group S and N was 3.8 and 5.8%, respectively. No patient showed CL grade IV. The incidences of sore throat at 1 (26.9 vs 19.2%, Pâ=â0.485) and 24âh (17.3 vs 13.5%, Pâ=â0.786, respectively) postoperatively were not significantly different between the group S and N. However, the incidence of subglottic injury was significantly higher in the group S, compared with the group N (65.4 vs 42.3%, Pâ=â0.030). The incidence of postoperative hoarseness did not differ significantly between the two groups.
Conclusions
The use of a stylet during McGrathÂŽ MAC videolaryngoscopic intubation did not have a significant impact on the incidence of postoperative sore throat in patients with a high Mallampati score. Avoiding the use of a stylet during intubation with McGrathÂŽ MAC videolaryngoscope may reduce the incidence of subglottic injury in such patients.
Trial registration
Clinical Research Information Service (identifier:
KCT0002427
, date of registration: June 12, 2017)
A prospective, randomized comparison of the LMA-protector⢠and i-gel⢠in paralyzed, anesthetized patients
Background
In the present study, we compare the LMA-Protector⢠and the i-gel⢠in terms of adequacy of the airway seal, insertion time, ease and accuracy of insertion, and the incidence of postoperative sore throat.
Methods
In 110 anesthetized and paralyzed adult patients, the i-gel⢠(nâ=â55) or the LMA-Protector⢠(nâ=â55) was inserted. The primary outcome was airway leak pressure. The secondary outcomes included the first-attempt success rate, insertion time, ease and accuracy of the device insertion, ease of gastric tube placement, blood staining on the device after removal, and incidence and severity of postoperative sore throat.
Results
The airway leak pressure was higher with the LMA-Protector⢠than with the i-gel⢠(31 [7] cmH2O vs. 27 [6] cmH2O, respectively; Pâ=â0.016). Insertion time was longer with the LMA-Protector⢠than with the i-gel⢠(27 [16] sec vs. 19 [16] sec, respectively, Pâ<â0.001), but ease of insertion and the first-attempt success rate were not different between the two groups. The LMA-Protector⢠provided a worse fiberoptic view of the vocal cords and more difficult gastric tube insertion than the i-gel⢠(both Pâ<â0.001). Blood staining on the device was more frequent with the LMA-Protector⢠than with the i-gel⢠(Pâ=â0.033). The incidence and severity of postoperative sore throat were not different between the two groups.
Conclusion
The LMA-Protector⢠provided a better airway sealing effect than the i-gelâ˘. However, it required a longer insertion time, provided a worse fiberoptic view of the vocal cords, and caused more mucosal injury compared to the i-gelâ˘.
Trial registration
ClinicalTrials.gov(NCT03078517). Registered prior to patient enrollment, Date of registration: Mar 13, 2017