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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

17.07.2017 | Reports of Original Investigations

Flexible bronchoscopic intubation through the AuraGain™ laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial

verfasst von: Berthold Moser, MD, Laurent Audigé, PhD, Christian Keller, MD, Joseph Brimacombe, MD, PhD, Lukas Gasteiger, MD, Heinz R. Bruppacher, MD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 11/2017

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Abstract

Purpose

AuraGain^TM, a novel third-generation laryngeal mask, can facilitate insertion of a gastric tube and provide the potential advantage of intubation. Data are lacking on intubation through the AuraGain laryngeal mask.

Methods

Eighty-eight hip or knee surgery patients were enrolled in this parallel randomized-controlled trial. We hypothesized that intubation time using the AuraGain laryngeal mask would be no longer than that for standard flexible bronchoscopic intubation over a slit Guedel tube, with a non-inferiority margin of five seconds. The following data were recorded during a maximum of three intubation attempts: intubation time, number of intubation attempts, degree of resistance to advance the endotracheal tube, and mask placement (i.e., Brimacombe score). Follow-up outcomes, including neck pain, hoarseness, and dysphagia, were also measured two and 24 hr postoperatively. Patients and outcome assessors remained blinded until the last examination.

Results

Mean intubation time was similar between the Guedel tube and AuraGain groups (23.6 sec vs 21.4 sec, respectively). The upper limit of the 95% confidence interval (CI) of the difference in mean intubation time between groups fell below our pre-specified non-inferiority margin; therefore, we found the AuraGain laryngeal mask to be non-inferior to the slit Guedel tube (adjusted group difference, −1.6 sec; 95% CI, −3.7 to 0.5). Successful intubation was achieved in the majority of patients (≥ 95%) in each group on the first attempt. No resistance to insertion of the endotracheal tube was encountered in the majority of patients in each group, and no complications were reported during the 24-hr postoperative period. There was no difference in the Brimacombe score or in the status of postoperative morbidity between the two groups.

Conclusion

We conclude that flexible bronchoscopic intubation through an AuraGain laryngeal mask can be achieved at least as fast as standard bronchoscopic intubation without contributing to additional patient morbidity or postoperative discomfort.

Trial registration

www.clinicaltrials.gov, NCT 02570269. Registered 23 September 2015.

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Titel: Flexible bronchoscopic intubation through the AuraGain™ laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial
verfasst von: Berthold Moser, MD
Laurent Audigé, PhD
Christian Keller, MD
Joseph Brimacombe, MD, PhD
Lukas Gasteiger, MD
Heinz R. Bruppacher, MD
Publikationsdatum: 17.07.2017
Verlag: Springer US
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 11/2017
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-017-0936-7

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Flexible bronchoscopic intubation through the AuraGain™ laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial