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, 36(8):3021–3027, August, 2022. PIMD: 35339355![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")
Paper 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\textless0.001); KingVision -11.9 N (p\textless0.001)) 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\textless0.001)) 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{defosse_dental_2022,
title = {Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study},
volume = {36},
issn = {1053-0770},
url = {https://www.sciencedirect.com/science/article/abs/pii/S1053-0770(22)00126-4 https://linkinghub.elsevier.com/retrieve/pii/S1053077022001264},
doi = {10.1053/j.jvca.2022.02.017},
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{\textless}0.001); KingVision -11.9 N (p{\textless}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{\textless}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.},
number = {8},
journal = {Journal of Cardiothoracic and Vascular Anesthesia},
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},
month = aug,
year = {2022},
note = {PIMD: 35339355},
pages = {3021--3027},
}
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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\\textless0.001); KingVision -11.9 N (p\\textless0.001)) 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\\textless0.001)) 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.","number":"8","journal":"Journal of Cardiothoracic and Vascular Anesthesia","author":[{"propositions":[],"lastnames":["Defosse"],"firstnames":["Jerome"],"suffixes":[]},{"propositions":[],"lastnames":["Kleinschmidt"],"firstnames":["Joris"],"suffixes":[]},{"propositions":[],"lastnames":["Schmutz"],"firstnames":["Axel"],"suffixes":[]},{"propositions":[],"lastnames":["Torsten"],"firstnames":["Loop"],"suffixes":[]},{"propositions":[],"lastnames":["Staat"],"firstnames":["Manfred"],"suffixes":[]},{"propositions":[],"lastnames":["Gatzweiler"],"firstnames":["Karl-Heinz"],"suffixes":[]},{"propositions":[],"lastnames":["Wappler"],"firstnames":["Frank"],"suffixes":[]},{"propositions":[],"lastnames":["Schieren"],"firstnames":["Mark"],"suffixes":[]}],"month":"August","year":"2022","note":"PIMD: 35339355","pages":"3021–3027","bibtex":"@article{defosse_dental_2022,\n\ttitle = {Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study},\n\tvolume = {36},\n\tissn = {1053-0770},\n\turl = {https://www.sciencedirect.com/science/article/abs/pii/S1053-0770(22)00126-4 https://linkinghub.elsevier.com/retrieve/pii/S1053077022001264},\n\tdoi = {10.1053/j.jvca.2022.02.017},\n\tabstract = {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{\\textless}0.001); KingVision -11.9 N (p{\\textless}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{\\textless}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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