Comparison of oral fiberoptic intubation via a modified guedel airway or a laryngeal mask airway in infants and children

Elsa Varghese, R. Nagaraj, R. Shwethapriya

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Though fiberoptic intubation (FOI) is considered the gold standard for securing a difficult airway in a child, it may be technically difficult in an anesthetized child. The hypothesis for this study was that it would be easier to perform FOI via a laryngeal mask airway (LMA) than a modified oropharyngeal airway with the advantage of maintaining anesthesia and oxygenation during the process. Materials and Methods: 30 children aged 6 months to 5 years undergoing elective surgery under general anesthesia were randomized to two groups to have fiberoptic bronchoscope (FOB) guided intubation either via a modified Guedel airway (FOB-ORAL) or a classic LMA (FOB-LMA). In the FOB-LMA group, the LMA was removed when a second smaller endotracheal tube was anchored to the proximal end of the tracheal tube in place. Results: Oral fiberoptic intubation was successful in all children. The first attempt success rate was 11/15 (73.33%) in the FOB-LMA group and 3/15 (20%) in the FOB-ORAL group ( P = 0.012). Subsequent attempts at intubation were successful after 90° anticlockwise rotation of the endotracheal tube over the FOB. The time taken for fiberoptic bronchoscopy was significantly less in FOB-LMA group (59.20 ± 42.85 sec vs 108.66 ± 52.43 sec). The incidence of desaturation was higher in the FOB-ORAL group (6/15 vs 0/15). Conclusion: In children, fiberoptic bronchoscopy and intubation via an LMA has the advantage of being easier, with shorter intubation time and continuous oxygenation and ventilation throughout the procedure. Removal of the LMA following intubation requires particular care.

Original languageEnglish
Pages (from-to)52-55
Number of pages4
JournalJournal of Anaesthesiology Clinical Pharmacology
Volume29
Issue number1
DOIs
Publication statusPublished - 01-01-2013
Externally publishedYes

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Bronchoscopes
Laryngeal Masks
Intubation
Bronchoscopy
General Anesthesia
Ventilation
Anesthesia

All Science Journal Classification (ASJC) codes

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)
  • Anesthesiology and Pain Medicine

Cite this

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title = "Comparison of oral fiberoptic intubation via a modified guedel airway or a laryngeal mask airway in infants and children",
abstract = "Background: Though fiberoptic intubation (FOI) is considered the gold standard for securing a difficult airway in a child, it may be technically difficult in an anesthetized child. The hypothesis for this study was that it would be easier to perform FOI via a laryngeal mask airway (LMA) than a modified oropharyngeal airway with the advantage of maintaining anesthesia and oxygenation during the process. Materials and Methods: 30 children aged 6 months to 5 years undergoing elective surgery under general anesthesia were randomized to two groups to have fiberoptic bronchoscope (FOB) guided intubation either via a modified Guedel airway (FOB-ORAL) or a classic LMA (FOB-LMA). In the FOB-LMA group, the LMA was removed when a second smaller endotracheal tube was anchored to the proximal end of the tracheal tube in place. Results: Oral fiberoptic intubation was successful in all children. The first attempt success rate was 11/15 (73.33{\%}) in the FOB-LMA group and 3/15 (20{\%}) in the FOB-ORAL group ( P = 0.012). Subsequent attempts at intubation were successful after 90° anticlockwise rotation of the endotracheal tube over the FOB. The time taken for fiberoptic bronchoscopy was significantly less in FOB-LMA group (59.20 ± 42.85 sec vs 108.66 ± 52.43 sec). The incidence of desaturation was higher in the FOB-ORAL group (6/15 vs 0/15). Conclusion: In children, fiberoptic bronchoscopy and intubation via an LMA has the advantage of being easier, with shorter intubation time and continuous oxygenation and ventilation throughout the procedure. Removal of the LMA following intubation requires particular care.",
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Comparison of oral fiberoptic intubation via a modified guedel airway or a laryngeal mask airway in infants and children. / Varghese, Elsa; Nagaraj, R.; Shwethapriya, R.

In: Journal of Anaesthesiology Clinical Pharmacology, Vol. 29, No. 1, 01.01.2013, p. 52-55.

Research output: Contribution to journalArticle

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