Using a shortened uncuffed endotracheal tube as a nasopharyngeal airway: a useful adjunct during fiberoptic intubation training among anesthesia residents

IF 0.8 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

African Health Sciences Pub Date : 2023-10-11 DOI:10.4314/ahs.v23i3.67

Hosni A Salem, Ayman Aly Rayan, Usama Abotaleb, Essam Shafiq M Abdel-wahap, Ismail A Elzoughari, Mohammed A Taha Alafifi, Walid Kamal Abdelbasset, Ahmed M Abodonya

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引用次数: 0

Abstract

Background: Fiberoptic intubation (FOI) is considered a beneficial modality used to intubate life-threatening airway patients.This study aims at assessing the effectiveness of shortened uncuffed endotracheal tube as a nasopharyngeal airway during FOI. Methods: Between January 2019 and March 2021, this prospective randomized controlled trial has enrolled 62 adult patients(56 males and 6 females) with normal airways scheduled for elective oral FOI classified American Society of Anesthesiologists(ASA I-III), their age ranged 20-60 years. The patients were randomized into two equal groups (31 per each); in group I, FOIwas carried using lingual traction, and in group II, FOI was carried out with lingual traction plus a shortened uncuffed endotrachealtube as a modified nasopharyngeal airway to maintain oxygenation. The time taken to successful tracheal intubation andother technical parameters have been measured. The heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2),end-tidal carbon dioxide (EtCO2), and any associated complications have been measured. Results: During insertion of the scope, the SpO2 was significantly decreased in group I (92.55 ± 7.94) compared to group II(97.42 ± 6.34), p=0.009. The heart rate, MAP, and EtCO2 were found to be insignificantly different in both groups (p>0.05).The time needed for intubation in group I (2.78±0.98 min) was prolonged compared with group II (1.95±1.02 min) p =0.002.The number of attempts was comparable in both groups, while the number of successful intubations from the 1st attempt was12 (39%) compared to 18 (58%) in groups I and II respectively, p=0.36. The overall success rate by juniors was 71% in group Icompared to 84% in group II, p=0.66 with a lower incidence of using rescue oxygen and other facilitating maneuvers. Conclusions: The modified nasopharyngeal airway is a useful modality to facilitate oral FOI by anesthesia resident trainees. Keywords: Nasopharyngeal airway; Endotracheal tube; Training of FOI.

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使用缩短的无袖气管内管作为鼻咽气道:在麻醉住院医师的纤维插管训练中有用的辅助工具

背景:光纤插管(FOI)被认为是一种有益的方式，用于插管危及生命的气道患者。本研究旨在评估FOI期间缩短无套管气管内管作为鼻咽气道的有效性。方法:在2019年1月至2021年3月期间，这项前瞻性随机对照试验招募了62名成人患者(56名男性和6名女性)，他们的气道正常，计划在美国麻醉医师协会(ASA I-III)分类的选择性口服FOI中进行，年龄在20-60岁之间。患者被随机分为两组(每组31人);I组采用舌牵引进行FOI, II组采用舌牵引加缩短的无袖气管内管作为改进的鼻咽气道以维持氧合。测量了气管插管成功所需的时间和其他技术参数。测量心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、潮末二氧化碳(EtCO2)及任何相关并发症。结果:置入镜时，I组SpO2(92.55±7.94)明显低于II组(97.42±6.34)，p=0.009。两组患者心率、MAP、EtCO2差异无统计学意义(p>0.05)。I组插管时间(2.78±0.98 min)较II组(1.95±1.02 min)延长，p =0.002。两组插管次数具有可比性，第一次插管成功12例(39%)，第1组和第2组分别为18例(58%)，p=0.36。i组的总体成功率为71%，而II组为84%，p=0.66，使用急救氧气和其他辅助操作的发生率较低。结论:改良鼻咽气道是一种有效的促进麻醉住院医师口服FOI的方式。关键词:鼻咽气道;气管内管;培训信息自由。

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来源期刊

African Health Sciences MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

0.00%

发文量

179

审稿时长

>12 weeks

期刊介绍： The African Health Sciences is an internationally refereed journal publishing original articles on research, clinical practice, public health, policy, planning, implementation and evaluation, in the health and related sciences relevant to Africa and the tropics. Its objectives are to: Advocate for and promote the growth of reading culture in sub Saharan Africa; Provide a high quality journal in which health and policy and other researchers and practitioners in the region can and world wide, can publish their work; Promote relevant health system research and publication in the region including alternative means of health care financing, the burden of and solution of health problems in marginalized urban and rural communities amongst the displaced and others affected by conflict; Promote research and the systematic collection and collation and publication of data on diseases and conditions of equity and influence; Promote development of evidence-based policies and guidelines for clinical, public health and other practitioners. African Health Sciences acknowledges support provided by the African Health Journals Partnership Project that is funded by the US National Institutes of Health (through the National Library of Medicine and the Fogarty International Center) and facilitated by the Council of Science Editors.