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Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial

OBJECTIVE: We hypothesised that videolaryngoscopy modifies practice of tracheal intubation. DESIGN: Randomised single-blinded study (video and no-video groups). SETTING: Three institutions: one academic, one non-profit and one profit. PARTICIPANTS: Patients >18 years, requiring orotracheal intuba...

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Autores principales: Belze, Olivier, Coppere, Zoé, Ouattara, Jonathan, Thion, Laurie-Anne, Paqueron, Xavier, Devys, Jean-Michel, Ma, Sabrina, Kennel, Titouan, Fischler, Marc, Le Guen, Morgan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8724720/
https://www.ncbi.nlm.nih.gov/pubmed/34980609
http://dx.doi.org/10.1136/bmjopen-2021-049275
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author Belze, Olivier
Coppere, Zoé
Ouattara, Jonathan
Thion, Laurie-Anne
Paqueron, Xavier
Devys, Jean-Michel
Ma, Sabrina
Kennel, Titouan
Fischler, Marc
Le Guen, Morgan
author_facet Belze, Olivier
Coppere, Zoé
Ouattara, Jonathan
Thion, Laurie-Anne
Paqueron, Xavier
Devys, Jean-Michel
Ma, Sabrina
Kennel, Titouan
Fischler, Marc
Le Guen, Morgan
author_sort Belze, Olivier
collection PubMed
description OBJECTIVE: We hypothesised that videolaryngoscopy modifies practice of tracheal intubation. DESIGN: Randomised single-blinded study (video and no-video groups). SETTING: Three institutions: one academic, one non-profit and one profit. PARTICIPANTS: Patients >18 years, requiring orotracheal intubation, without predicted difficult intubation. Non-inclusion criterion was patients requiring a rapid-sequence intubation. 300 patients were included, 271 randomised, 256 analysed: 123 in the no-video and 133 in the video groups. INTERVENTION: Tracheal intubation using a McGrath Mac videolaryngoscope, the sequence being video recorded. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the proportion of intubations where assistance is necessary on request of the operator. Secondary outcomes included intraoperative variables (intubation difficulty scale and its components, percentage of glottic opening score, oesophageal Intubation, duration of intubation, removal of the screen cover in the no-video group, global evaluation of the ease of intubation, bispectral index, heart rate and blood pressure), intraoperative and postoperative complications (hoarseness or sore throat) and cooperation of the anaesthesiology team. RESULTS: Requirement for assistance was not decreased in the Video group: 36.1% (95% CI 27.9 to 44.9) vs 45.5% (95% CI 36.5 to 54.7) in the no-video group, p=0.74; OR: 0.7 (95% CI 0.4 to 1.1) and absolute risk: 0.10 (95% CI −0.03 to 0.22). Intubation difficulty scale was similar in both groups (p=0.05). Percentage of glottic opening score was better in the Video group (median of 100 (95% CI (100 to 100) and 80 (95%CI (80 to 90) in the no-video group; p<0.001) as Cormack and Lehane grade (p=0001). Ease of intubation was considered better in the video group (p<0.001). Other secondary outcomes were similar between groups. Screen cover was removed in 7.3% (95% CI (2.7 to 11.9)) of the cases in the video group. No serious adverse event occurred. Communication and behaviour within the anaesthesia team were appropriate in all cases. CONCLUSION: In patients without predicted difficult intubation, videolaryngoscopy did not decrease the requirement for assistance to perform intubation. TRIAL REGISTRATION NUMBER: NCT02926144; Results.
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spelling pubmed-87247202022-01-18 Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial Belze, Olivier Coppere, Zoé Ouattara, Jonathan Thion, Laurie-Anne Paqueron, Xavier Devys, Jean-Michel Ma, Sabrina Kennel, Titouan Fischler, Marc Le Guen, Morgan BMJ Open Anaesthesia OBJECTIVE: We hypothesised that videolaryngoscopy modifies practice of tracheal intubation. DESIGN: Randomised single-blinded study (video and no-video groups). SETTING: Three institutions: one academic, one non-profit and one profit. PARTICIPANTS: Patients >18 years, requiring orotracheal intubation, without predicted difficult intubation. Non-inclusion criterion was patients requiring a rapid-sequence intubation. 300 patients were included, 271 randomised, 256 analysed: 123 in the no-video and 133 in the video groups. INTERVENTION: Tracheal intubation using a McGrath Mac videolaryngoscope, the sequence being video recorded. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the proportion of intubations where assistance is necessary on request of the operator. Secondary outcomes included intraoperative variables (intubation difficulty scale and its components, percentage of glottic opening score, oesophageal Intubation, duration of intubation, removal of the screen cover in the no-video group, global evaluation of the ease of intubation, bispectral index, heart rate and blood pressure), intraoperative and postoperative complications (hoarseness or sore throat) and cooperation of the anaesthesiology team. RESULTS: Requirement for assistance was not decreased in the Video group: 36.1% (95% CI 27.9 to 44.9) vs 45.5% (95% CI 36.5 to 54.7) in the no-video group, p=0.74; OR: 0.7 (95% CI 0.4 to 1.1) and absolute risk: 0.10 (95% CI −0.03 to 0.22). Intubation difficulty scale was similar in both groups (p=0.05). Percentage of glottic opening score was better in the Video group (median of 100 (95% CI (100 to 100) and 80 (95%CI (80 to 90) in the no-video group; p<0.001) as Cormack and Lehane grade (p=0001). Ease of intubation was considered better in the video group (p<0.001). Other secondary outcomes were similar between groups. Screen cover was removed in 7.3% (95% CI (2.7 to 11.9)) of the cases in the video group. No serious adverse event occurred. Communication and behaviour within the anaesthesia team were appropriate in all cases. CONCLUSION: In patients without predicted difficult intubation, videolaryngoscopy did not decrease the requirement for assistance to perform intubation. TRIAL REGISTRATION NUMBER: NCT02926144; Results. BMJ Publishing Group 2022-01-03 /pmc/articles/PMC8724720/ /pubmed/34980609 http://dx.doi.org/10.1136/bmjopen-2021-049275 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Anaesthesia
Belze, Olivier
Coppere, Zoé
Ouattara, Jonathan
Thion, Laurie-Anne
Paqueron, Xavier
Devys, Jean-Michel
Ma, Sabrina
Kennel, Titouan
Fischler, Marc
Le Guen, Morgan
Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title_full Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title_fullStr Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title_full_unstemmed Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title_short Influence of videolaryngoscopy using McGrath Mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
title_sort influence of videolaryngoscopy using mcgrath mac on the need for a helper to perform intubation during general anaesthesia: a multicentre randomised video-no-video trial
topic Anaesthesia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8724720/
https://www.ncbi.nlm.nih.gov/pubmed/34980609
http://dx.doi.org/10.1136/bmjopen-2021-049275
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