%0 Journal Article %1 Defosse2022 %A Defosse, Jerome %A Kleinschmidt, Joris %A Schmutz, Axel %A Torsten, Loop %A Staat, Manfred %A Gatzweiler, Karl-Heinz %A Wappler, Frank %A Schieren, Mark %D 2022 %J Journal of Cardiothoracic and Vascular Anesthesia %K imported %R 10.1053/j.jvca.2022.02.017 %T Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study %U https://www.sciencedirect.com/science/article/abs/pii/S1053-0770(22)00126-4 https://linkinghub.elsevier.com/retrieve/pii/S1053077022001264 %X 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 (11.3-22.02.1-110.5) N) was used compared to direct laryngoscopy (21.0 (14.1-28.54.7-168.6) 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 (17.1-41.99.2-275.0)) s (p<0.001)) in comparison to direct laryngoscopy (20.8 (15.9-27.48.7-198.6) 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{Defosse2022, 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.}, added-at = {2022-03-22T23:17:08.000+0100}, 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}, biburl = {https://www.bibsonomy.org/bibtex/269c34d7d9d6f27efc66ac762ba8a17b7/staat}, doi = {10.1053/j.jvca.2022.02.017}, interhash = {a0403f7a8c893d8a076ed1f3328f672b}, intrahash = {69c34d7d9d6f27efc66ac762ba8a17b7}, issn = {1053-0770}, journal = {Journal of Cardiothoracic and Vascular Anesthesia}, keywords = {imported}, month = feb, timestamp = {2022-03-22T23:17:08.000+0100}, title = {{Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study}}, url = {https://www.sciencedirect.com/science/article/abs/pii/S1053-0770(22)00126-4 https://linkinghub.elsevier.com/retrieve/pii/S1053077022001264}, year = 2022 }