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Videolaryngoscopy improves intubation condition in morbidly obese patients

Published online by Cambridge University Press:  01 December 2007

J. Marrel ,
C. Blanc ,
P. Frascarolo  and
L. Magnusson
J. Marrel
Affiliation:
University Hospital, Department of Anaesthesiology, Lausanne, Switzerland
C. Blanc
Affiliation:
University Hospital, Department of Anaesthesiology, Lausanne, Switzerland
P. Frascarolo
Affiliation:
University Hospital, Department of Anaesthesiology, Lausanne, Switzerland
L. Magnusson*
Affiliation:
University Hospital, Department of Anaesthesiology, Lausanne, Switzerland
*
Correspondence to: Lennart Magnusson, Department of Anaesthesiology, University Hospital, CHUV BH-10, Lausanne 1011, Switzerland. E-mail: [email protected]; Tel: +41 21 314 20 07; Fax: +41 21 314 20 04
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Summary

Background and objective

Tracheal intubation may be more difficult in morbidly obese patients (body mass index >35 kg m−2) than in the non-obese. Recently, new video-assisted intubation devices have been developed. After some experience with videolaryngoscopy, we hypothesized that it could improve the laryngoscopic view in this specific population and therefore facilitate intubation. The aim of this study was to assess the benefit of a videolaryngoscope on the grade of laryngoscopy in morbid obesity.

Methods

We studied 80 morbidly obese patients undergoing bariatric surgery. They were randomly assigned to one of two groups. One group was intubated with the help of the videolaryngoscope and in the control group the screen of the videolaryngoscope was hidden to the intubating anaesthesiologist. The primary end-point of the study was to assess in both groups the Cormack and Lehane direct and indirect grades of laryngoscopy. The duration of intubation, the number of attempts needed as well as the minimal SPO2 reached during the intubation process were measured.

Results

Grade of laryngoscopy was significantly lower with the videolaryngoscope compared with the direct vision (P < 0.001). When the grade of laryngoscopy was higher than one with the direct laryngoscopy (n = 30), it was lower in 28 cases with the videolaryngoscope and remained the same only in two cases (P < 0.001). The minimal SPO2 reached during the intubation was higher with the videolaryngoscope but it did not reach statistical significance.

Conclusions

In morbidly obese patients, the use of the videolaryngoscope significantly improves the visualization of the larynx and thereby facilitates intubation.

Keywords

OBESITY MORBIDINTUBATION INTRATRACHEALLARYNGOSCOPY, videolaryngoscope
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 12 , December 2007 , pp. 1045 - 1049
Copyright
Copyright © European Society of Anaesthesiology 2007

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