A Non-Inferiority Study of the Speed and Success of Nasotracheal Intubation in Maxillofacial Surgeries Using Macintosh Direct Laryngoscope versus Sanyar® Video Laryngoscope

Pejman Pourfakhr; Mehran Sadeghi; Farhad Etezadi; Parisa Kianpour; Azam Biderafsh; Mohammad Reza Khajavi

doi:10.18502/aacc.v10i3.15687

Pejman Pourfakhr Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran.
Mehran Sadeghi Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran.
Farhad Etezadi Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran.
Parisa Kianpour Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran.
Azam Biderafsh Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza Khajavi Anesthesia, Critical Care, and Pain Management Research Center,Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i3.15687

Keywords: Nasotracheal-endotracheal intubation; Airway management; Direct laryngoscopy; Sanyar® video laryngoscopy; Maxillofacial surgery

Abstract

Background: The recently developed blade design of the Sanyar® video laryngoscope yields an exceptionally precise visualization of the larynx, thereby easing the process of tracheal intubation.

Objectives: A non-inferiority clinical investigation, to assess the efficacy of the Sanyar® as compared to the Macintosh® direct laryngoscope for nasotracheal intubation in the context of maxillofacial surgeries.

Methods: 78 patients for maxillofacial surgery were divided randomly into two groups and intubated through the nose using either the Sanyar® or Macintosh® laryngoscope after anesthesia was induced. The study measured intubation time and secondary objectives included success rate, attempts, and hemodynamic changes in two groups.

Results: 40 eligible patients in the Sanyar® and 38 in the Macintosh® group were involved. Of all, 42(53.8%) were men and 36(46.2%) were women. The average age of patients in the Sanyar® and Mackintosh groups was (31.62±13.41) and (30.81±10.89), respectively. 39(98%) of the Sanyar® group and 33(86%) of the Macintosh® group had successful laryngoscopy and intubation, with a P-value<0.034. Sanyar® group had a significantly shorter intubation time than Macintosh® (P-value<0.001). Hemodynamic changes before and after laryngoscopy and intubation had no significant differences between the two groups.

Conclusion: The Sanyar® video laryngoscope reduced the time of nasal tracheal intubation in maxillofacial surgery compared to direct laryngoscopy and improved the success rate of the first intubation attempt.