Postoperative Complications, Patient Safety, and Comfort of the Oral Fiberoptic Bronchoscopy-guided Intubation Compared with the Oral laryngoscope Intubation
Science Journal of Public Health
Volume 8, Issue 4, July 2020, Pages: 99-107
Received: May 5, 2020;
Accepted: Jun. 15, 2020;
Published: Jun. 29, 2020
Views 222 Downloads 84
Troels Edsen, Department of Neuroanesthesiology, the Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Marian Petersen, Neuroscience Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Finn Borgbjerg Moltke, Department of Neuroanesthesiology, the Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Veterinary Clinical and Animal Science, University of Copenhagen, Copenhagen, Denmark
Carrinna Aviaja Hansen, Department of Neuroanesthesiology, the Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Introduction: Postoperative sore throat (POST) and hoarseness is an on-going worldwide challenge after general anaesthesia. In this study, we hypothesised that patients intubated with the fiberoptic bronchoscope–guided intubation device differs in POST and hoarseness from other patients intubated with the oral Macintosh laryngoscope–guided intubation device. If this could be confirmed, the guideline of peri anaesthesia may need to be different. Objective: This study aimed to investigate whether fiberoptic intubation can provide increased patient safety and comfort compared to standard laryngoscope intubation performed by nurse anaesthetists. Methods: Within this single-blinded, consecutively controlled clinical trial two hundred and nine patients scheduled for elective neurosurgical treatment requiring intratracheal intubation, were randomly divided into intervention and control group. The intervention group received fiberoptic bronchoscopy–guided intubation during anaesthesia as well as nursing and postoperative treatment based on conventional drug therapy after neurosurgical treatment. The control group received intubation during anaesthesia, as usual, using Macintosh laryngoscope intubation, and postoperative treatment based on conventional drug therapy after neurosurgical treatment. Data regarding the patient safety were obtained during peri anaesthesia, and data concerning the patient comfort were collected on the first postoperative day. Statistical analyses were performed using SPSS version 22. Results: Seven patients were excluded (3.3%); thus, the final population consisted of two hundred and two patients: 62.4% women, the mean age of 52 years (20 to 86 years), 106 (52.5%) patients in the fiberoptic intubation group. A statistically significant difference was found between groups according to patient safety, measured by the number of anaesthetists involved P=0.024 in favour of the fiberoptic intubation device. A trend was pointing to increased pain in the mouth and throat P=0.053, when intubated with the laryngoscope. Other patient safety and comfort measurements showed no statistically significant differences between groups. Conclusions: The study directs attention to some possible benefits of using the fiberoptic intubation device, which may improve patient safety and comfort when compared to standard laryngoscope intubation.
Finn Borgbjerg Moltke,
Carrinna Aviaja Hansen,
Postoperative Complications, Patient Safety, and Comfort of the Oral Fiberoptic Bronchoscopy-guided Intubation Compared with the Oral laryngoscope Intubation, Science Journal of Public Health.
Vol. 8, No. 4,
2020, pp. 99-107.
El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: a systematic review. Anaesthesia. 2016; 71 (6): 706-17.
Biro P, Seifert B, Pasch T. Complaints of sore throat after tracheal intubation: a prospective evaluation. European journal of anaesthesiology. 2005; 22 (4): 307-11.
Tachibana N, Niiyama Y, Yamakage M. Less postoperative sore throat after nasotracheal intubation using a fiberoptic bronchoscope than using a Macintosh laryngoscope: A double-blind, randomized, controlled study. Journal of clinical anesthesia. 2017; 39: 113-7.
Xu YJ, Wang SL, Ren Y, Zhu Y, Tan ZM. A smaller endotracheal tube combined with intravenous lidocaine decreases post-operative sore throat - a randomized controlled trial. Acta anaesthesiologica Scandinavica. 2012; 56 (10): 1314-20.
Aqil M, Khan MU, Mansoor S, Mansoor S, Khokhar RS, Narejo AS. Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope. BMC anesthesiology. 2017; 17 (1): 127.
Chang JE, Kim H, Han SH, Lee JM, Ji S, Hwang JY. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation. Anesthesia and analgesia. 2017; 125 (4): 1240-5.
Seo JH, Cho CW, Hong DM, Jeon Y, Bahk JH. The effects of thermal softening of double-lumen endobronchial tubes on postoperative sore throat, hoarseness and vocal cord injuries: a prospective double-blind randomized trial. British journal of anaesthesia. 2016; 116 (2): 282-8.
Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. The Cochrane database of systematic reviews. 2015 (7): Cd004081.
Park JH, Lee YC, Lee J, Kim H, Kim HC. The influence of high-dose intraoperative remifentanil on postoperative sore throat: a prospective randomized study: A CONSORT compliant article. Medicine. 2018; 97 (50): e13510.
Kuriyama A, Maeda H, Sun R, Aga M. Topical application of corticosteroids to tracheal tubes to prevent postoperative sore throat in adults undergoing tracheal intubation: a systematic review and meta-analysis. Anaesthesia. 2018; 73 (12): 1546-56.
Yang HL, Liu FC, Tsai SC, Tsay PK, Lin HT, Liu HE. Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia. BioMed research international. 2016; 2016: 4582439.
Kuriyama A, Aga M, Maeda H. Topical benzydamine hydrochloride for prevention of postoperative sore throat in adults undergoing tracheal intubation for elective surgery: a systematic review and meta-analysis. Anaesthesia. 2018; 73 (7): 889-900.
Zhao X, Cao X, Li Q. Dexamethasone for the prevention of postoperative sore throat: a systematic review and meta-analysis. Journal of clinical anesthesia. 2015; 27 (1): 45-50.
Honarmand A, Safavi M, Safaei Arani A, Shokrani O. The efficacy of different doses of liquorice gargling for attenuating postoperative sore throat and cough after tracheal intubation. European journal of anaesthesiology. 2016; 33 (8): 595-6.
Mayhood J, Cress K. Effectiveness of ketamine gargle in reducing postoperative sore throat in patients undergoing airway instrumentation: a systematic review. JBI database of systematic reviews and implementation reports. 2015; 13 (9): 244-78.
Maruyama K, Sakai H, Miyazawa H, Toda N, Iinuma Y, Mochizuki N, et al. Sore throat and hoarseness after total intravenous anaesthesia. British journal of anaesthesia. 2004; 92 (4): 541-3.
Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. British journal of anaesthesia. 2002; 88 (4): 582-4.
Chen KT, Tzeng JI, Lu CL, Liu KS, Chen YW, Hsu CS, et al. Risk factors associated with postoperative sore throat after tracheal intubation: an evaluation in the postanesthetic recovery room. Acta anaesthesiologica Taiwanica: official journal of the Taiwan Society of Anesthesiologists. 2004; 42 (1): 3-8.
Collins SR, Blank RS. Fiberoptic intubation: an overview and update. Respiratory care. 2014; 59 (6): 865-78; discussion 78-80.
World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013; 310 (20): 2191-4.
Heidegger T, Starzyk L, Villiger CR, Schumacher S, Studer R, Peter B, et al. Fiberoptic intubation and laryngeal morbidity: a randomized controlled trial. Anesthesiology. 2007; 107 (4): 585-90.
Cirilla DJ, 2nd, Ngo J, Vaisman V, Daly C, Ata A, Sandison M, et al. Does the incidence of sore throat postoperatively increase with the use of a traditional intubation blade or the GlideScope? Journal of clinical anesthesia. 2015; 27 (8): 646-51.
Lee JY, Sim WS, Kim ES, Lee SM, Kim DK, Na YR, et al. Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients. The Journal of international medical research. 2017; 45 (2): 744-52.
Radu AD, Miled F, Marret E, Vigneau A, Bonnet F. Pharyngo-laryngeal discomfort after breast surgery: comparison between orotracheal intubation and laryngeal mask. Breast (Edinburgh, Scotland). 2008; 17 (4): 407-11.
Jaensson M, Gupta A, Nilsson U. Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study. BMC anesthesiology. 2014; 14: 56.
Stomberg MW, Sjostrom B, Haljamae H. Routine intra-operative assessment of pain and/or depth of anaesthesia by nurse anaesthetists in clinical practice. Journal of clinical nursing. 2001; 10 (4): 429-36.
Aagaard K, Laursen BS, Rasmussen BS, Sorensen EE. Interaction Between Nurse Anesthetists and Patients in a Highly Technological Environment. Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses. 2017; 32 (5): 453-63.
Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesthesia and analgesia. 1999; 89 (3): 652-8.