Comparison of the intubation success rate between the intubating catheter and videolaryngoscope in difficult airways: a prospective randomized trial.

BACKGROUND: Several devices and algorithms have already been examined and compared for difficult airway management. However, there is no existing study comparing the success of the Intubating Catheter (IC) and the Videolaryngoscope (VL) in patients who are difficult to intubate. We aimed to compare Frova IC and McGrath VL in terms of intubation success rates in patients with difficult intubation. METHODS: This prospective, randomized study was performed in an university hospital. Patients who underwent an operation under general anesthesia and whom airway management process was deemed difficult were included in this study. Patients were randomly divided into two groups by envelopes containing a number: the intubating catheter group (Group IC), intubated using the Frova IC, and the videolaryngoscope group (Group VL), intubated using the McGrath VL. Study data were collected by a technician who was blind to the study groups and the type of device used in the intubation procedure. RESULTS: A total of 49 patients with difficult airway were included in the study, including 25 patients in the Frova IC Group and 24 patients in the McGrath VL Group. The rate of successful intubation was determined to be 88% in Group IC and 66% in Group VL (p = 0.074). The mean duration of intubation attempt in Group VL was 44.62 seconds, whereas in Group IC, it was 51.12 seconds (p = 0.593). Group VL was found to have a significantly lower Cormack-Lehane grade compared to Group IC (p < 0.001). CONCLUSION: Frova IC is a candidate to be an indispensable instrument in terms of cost-effectiveness in clinics such as anesthesia and emergency medicine, where difficult intubation cases are frequently encountered. However, the combination of Frova IC and McGrath VL seems to be more successful in difficult intubation situations, so future studies should focus on using these two devices together.

Effects of different fresh gas flows and different anesthetics on airway temperature and humidity in surgical patients: a prospective observational study.

This study was aimed to investigate the effects of different fresh gas (oxygen + air) flow rates and different anesthetics on airway temperature and humidity when using the same anesthesia machine in patients undergoing general anesthesia. In this prospective, observational study, 240 patients with American Society of Anesthesiologists (ASA) I-II between the age of 18-65 years to be operated under general anesthesia were enrolled and divided into two groups according to the fresh gas flow rate (3-6 L/min). Each of the two main groups was further divided into three subgroups according to the administered anesthetic gases and drugs. The resulting six groups were further divided into two subgroups according to whether the heat and humidity exchanger filter (HME) was attached to the breathing circuit, and the study was carried out on a total of 12 groups. The temperature and humidity of the inspired air were recorded every 10 minutes using an electronic thermo-hygrometer. The inspired temperature and humidity were greater in patients ventilated at 3 L/min compared to the 6 L/min group and in HME (+) patients compared to HME (-), regardless of the type of anesthetics. HME application makes the air more physiological for the respiratory tract by increasing the temperature and humidity of the air regardless of the anesthetic agent. This study was approved by Ethics Committee Review of Selcuk University Faculty of Medicine (No. 2017/261) in September 2017, and was registered in the Clinical Trial Registry (identifier No. NCT04204746) on December 19, 2019.