Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study. Defosse, J., Kleinschmidt, J., Schmutz, A., Torsten, L., Staat, M., Gatzweiler, K., Wappler, F., & Schieren, M. Journal of Cardiothoracic and Vascular Anesthesia, 2, 2022. ![Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study [link]](https://bibbase.org/img/filetypes/link.svg "link")
Website doi abstract bibtex Objectives : To quantify dental forces during double-lumen tube intubations with different laryngoscopy techniques. Design : Experimental biomechanical manikin study. Setting : Two German university hospitals. Participants : 104 anaesthetists with varying levels of experience. Interventions : Participants performed a sequence of intubations on a manikin equipped with hidden forces sensors in the maxillary incisors. Different laryngoscopy techniques were evaluated under normal and difficult airway conditions. Direct laryngoscopy was compared to different videolaryngoscopy techniques: the C-MAC with a Macintosh blade, the GlideScope and the KingVision with hyperangulated blades. Measurements and Main Results : A total of 624 intubations were evaluated. In normal airway conditions, the median (IQR [range]) peak forces were significantly lower when the GlideScope (15.7 (11.3-22.0[2.1-110.5]) N) was used compared to direct laryngoscopy (21.0 (14.1-28.5[4.7-168.6]) N) (p=0.007). In difficult airways, resulting forces were reduced using hyperangulated videolaryngoscopes (GlideScope -13.7 N (p<0.001); KingVision -11.9 N (p<0.001)) compared to direct laryngoscopy, respectively. The time to intubation was prolonged with the use of the KingVision (25.5 (17.1-41.9[9.2-275.0])) s (p<0.001)) in comparison to direct laryngoscopy (20.8 (15.9-27.4[8.7-198.6]) s). The C-MAC demonstrated the shortest time to intubation. Conclusions : While hyperangulated videolaryngoscopes improve dental strain, clinicians should also consider the time to intubation, which is shortest with non-hyperangulated videoblades, when choosing a laryngoscopy technique on an individual patient basis.
@article{
title = {Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study},
type = {article},
year = {2022},
websites = {https://www.sciencedirect.com/science/article/abs/pii/S1053-0770(22)00126-4,https://linkinghub.elsevier.com/retrieve/pii/S1053077022001264},
month = {2},
id = {ea2198db-c5da-35ea-8b3b-9e70b17a5405},
created = {2022-02-14T14:51:49.305Z},
file_attached = {false},
profile_id = {93ec0d5b-403c-3f87-b702-40b6362f05e6},
last_modified = {2022-02-17T20:32:45.498Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {true},
hidden = {false},
citation_key = {Defosse2022},
private_publication = {false},
abstract = {Objectives : To quantify dental forces during double-lumen tube intubations with different laryngoscopy techniques. Design : Experimental biomechanical manikin study. Setting : Two German university hospitals. Participants : 104 anaesthetists with varying levels of experience. Interventions : Participants performed a sequence of intubations on a manikin equipped with hidden forces sensors in the maxillary incisors. Different laryngoscopy techniques were evaluated under normal and difficult airway conditions. Direct laryngoscopy was compared to different videolaryngoscopy techniques: the C-MAC with a Macintosh blade, the GlideScope and the KingVision with hyperangulated blades. Measurements and Main Results : A total of 624 intubations were evaluated. In normal airway conditions, the median (IQR [range]) peak forces were significantly lower when the GlideScope (15.7 (11.3-22.0[2.1-110.5]) N) was used compared to direct laryngoscopy (21.0 (14.1-28.5[4.7-168.6]) N) (p=0.007). In difficult airways, resulting forces were reduced using hyperangulated videolaryngoscopes (GlideScope -13.7 N (p<0.001); KingVision -11.9 N (p<0.001)) compared to direct laryngoscopy, respectively. The time to intubation was prolonged with the use of the KingVision (25.5 (17.1-41.9[9.2-275.0])) s (p<0.001)) in comparison to direct laryngoscopy (20.8 (15.9-27.4[8.7-198.6]) s). The C-MAC demonstrated the shortest time to intubation. Conclusions : While hyperangulated videolaryngoscopes improve dental strain, clinicians should also consider the time to intubation, which is shortest with non-hyperangulated videoblades, when choosing a laryngoscopy technique on an individual patient basis.},
bibtype = {article},
author = {Defosse, Jerome and Kleinschmidt, Joris and Schmutz, Axel and Torsten, Loop and Staat, Manfred and Gatzweiler, Karl-Heinz and Wappler, Frank and Schieren, Mark},
doi = {10.1053/j.jvca.2022.02.017},
journal = {Journal of Cardiothoracic and Vascular Anesthesia}
}
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Design : Experimental biomechanical manikin study. Setting : Two German university hospitals. Participants : 104 anaesthetists with varying levels of experience. Interventions : Participants performed a sequence of intubations on a manikin equipped with hidden forces sensors in the maxillary incisors. Different laryngoscopy techniques were evaluated under normal and difficult airway conditions. Direct laryngoscopy was compared to different videolaryngoscopy techniques: the C-MAC with a Macintosh blade, the GlideScope and the KingVision with hyperangulated blades. Measurements and Main Results : A total of 624 intubations were evaluated. In normal airway conditions, the median (IQR [range]) peak forces were significantly lower when the GlideScope (15.7 (11.3-22.0[2.1-110.5]) N) was used compared to direct laryngoscopy (21.0 (14.1-28.5[4.7-168.6]) N) (p=0.007). In difficult airways, resulting forces were reduced using hyperangulated videolaryngoscopes (GlideScope -13.7 N (p<0.001); KingVision -11.9 N (p<0.001)) compared to direct laryngoscopy, respectively. The time to intubation was prolonged with the use of the KingVision (25.5 (17.1-41.9[9.2-275.0])) s (p<0.001)) in comparison to direct laryngoscopy (20.8 (15.9-27.4[8.7-198.6]) s). The C-MAC demonstrated the shortest time to intubation. 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Design : Experimental biomechanical manikin study. Setting : Two German university hospitals. Participants : 104 anaesthetists with varying levels of experience. Interventions : Participants performed a sequence of intubations on a manikin equipped with hidden forces sensors in the maxillary incisors. Different laryngoscopy techniques were evaluated under normal and difficult airway conditions. Direct laryngoscopy was compared to different videolaryngoscopy techniques: the C-MAC with a Macintosh blade, the GlideScope and the KingVision with hyperangulated blades. Measurements and Main Results : A total of 624 intubations were evaluated. In normal airway conditions, the median (IQR [range]) peak forces were significantly lower when the GlideScope (15.7 (11.3-22.0[2.1-110.5]) N) was used compared to direct laryngoscopy (21.0 (14.1-28.5[4.7-168.6]) N) (p=0.007). 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