Comparison of the Intubation Success Rate in Video Laryngoscopy versus Direct Laryngoscopy in Patients with Philadelphia Collar: A Randomized Clinical Trial

Reza  Atef-Yekta; Arash Heroabadi; Amin Karami

doi:10.18502/aacc.v9i2.12516

Reza Atef-Yekta Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arash Heroabadi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Amin Karami Department of Orthopedic Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v9i2.12516

Keywords: General anesthesia; Intubation; Laryngoscopy

Abstract

Background: Video laryngoscopy (VL) and direct laryngoscopy (DL) are two approaches to provide secure airway for patients with compromised airways. This study aims to compare the intubation success rate in video laryngoscopy versus direct laryngoscopy in patients with Philadelphia collars.

Methods: 172 patients with cervical collars who have undergone general anesthesia were enrolled. After induction of anesthesia for all patients, an oral airway was used to facilitate the ventilation. A VL approach in Group A and DL approach in Group B were used. In order to evaluate the effectiveness of each method, we considered related parameters, including intubation time, the number of intubation attempts, Cormack-Lehane (CL) score, orodental injuries, heart rate, and blood pressure 3 minutes after intubation, oxygen saturation, neck circumference, and BMI.

Results: The ratio of first-attempt intubations was not different among the two groups (P = 1.00). The mean [SD] time for intubation was shorter with DL vs VL (p<0.0001). There were almost equal rates of CL grades 1 and 2 (67.5% and 29%) using the VL than with the. The mean [SD] mean arterial pressure in VL vs DL was 86.17 mmHg vs 90.88 mmHg (p = 0.086).

Conclusion: According to our results, there was no significant difference in complications and hemodynamic changes after intubation in both groups, but the intubation duration was significant shorter in DL group.