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Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway

Kleine-Brueggeney, M. ; Theiler, L. ; Urwyler, N. ; Vogt, A. ; Greif, R.

In: British Journal of Anaesthesia, 2011, vol. 107, no. 2, p. 251-257

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    Titre
    • Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway
    Auteur
    • Kleine-Brueggeney, M.. Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland
    • Theiler, L.. Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland
    • Urwyler, N.. Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland
    • Vogt, A.. Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland
    • Greif, R.. Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • British Journal of Anaesthesia, 2011, vol. 107, no. 2, p. 251-257. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:304480
    Summary
    Background The i-gel™ is a single-use supraglottic airway device (SAD) that allows fibreoptic-guided tracheal intubation through the device. Until now, no prospective data for this procedure are available. Therefore, in a prospective randomized controlled trial, we evaluated fibreoptic-guided tracheal intubation with a standard Rüsch™ PVC tracheal tube (TT) through the i-gel™ compared with the single-use ILMA™ (sILMA™) TT through the sILMA™ in patients with a predicted difficult airway. Methods With ethics committee approval and written informed consent, 160 patients were randomly assigned to either SAD. After placement of the SAD, a fibreoptic bronchoscope was introduced into the trachea as a railroad for the TT. Primary outcome variable was the first-attempt fibreoptic-guided intubation success rate. Secondary variables included time for insertion and intubation, airway leak pressures, fibreoptic view, and adverse events. Data are presented as mean (sd) or percentages. A P-value of <0.05 was considered statistically significant. Results Fibreoptic-guided intubation was successful at the first attempt in 76 patients (96%) using the i-gel™ and in 71 patients (90%) using the sILMA™ (P=0.21). Most of the failed intubations were rescued by conventional laryngoscopy. Airway leak pressure was higher for the sILMA™. There were no problems during removal of either type of SAD. Conclusions Fibreopic-guided tracheal intubation through the i-gel™ using a standard Rüsch™ Magill TT is successful and an alternative to the sILMA™ with the sILMA™ TT