Comparison of plastic and metallic single-use and metallic reusable laryngoscope blades : a randomised controlled trial
CONTEXT: Plastic single-use laryngoscope blades have been found to increase the difficulty of intubation. Metallic single-use blades may represent an alternative.
OBJECTIVE: To compare the rates of intubation failure at first laryngoscopy using metallic single-use, plastic single-use and metallic reusable laryngoscope blades.
DESIGN: Randomised, superiority, single-centre, controlled trial.
SETTING: Operating theatres at a University Hospital from January 2008 to August 2009.
PATIENTS: A total of 1863 adults requiring general anaesthesia.
INTERVENTION: Patients were randomised to one of three laryngoscope blades: metallic single-use, plastic single-use or metallic reusable.
MAIN OUTCOME MEASURE: The primary end-point was the number of intubation failures at first laryngoscopy. Secondary end-points were glottic exposure and the Intubation Difficulty Scale.
RESULTS: The failure rate (absolute difference: 95% confidence interval) at the first attempt was greater for the plastic single-use blades (8.1%) than for the metallic reusable [3.2% (4.9%: 2.2 to 7.6%); P < 0.001] and metallic reusable blades [4.0% (4.0%: 1.2 to 6.9%); P < 0.006]. No difference was found between the metallic reusable and metallic single-use groups (0.9%: -1.3 to 3.1%). Scoring on the Intubation Difficulty Scale [median (interquartile range)] was higher in the plastic single-use group [1 (0 to 2)] than in the metallic groups [metallic reusable: 0 (0 to 1); P < 0.001 and metallic single-use: 0 (0 to 1); P < 0.007] groups. Glottic exposure was significantly better in the metallic reusable group (modified Cormack & Lehane score III and IV: 3.7%) compared with the plastic single-use group (modified Cormack & Lehane score III and IV: 9.4%; P < 0.03).
CONCLUSION: The rates of failed intubation at first laryngoscopy were similar in the metallic reusable and metallic reusable groups, but greater in the plastic single-use group.
| Errataetall: |
CommentIn: Eur J Anaesthesiol. 2013 Apr;30(4):139-41. - PMID 23471117 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
European journal of anaesthesiology - 30(2013), 4 vom: 15. Apr., Seite 163-9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Buléon, Clément [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 26.08.2013 Date Revised 18.04.2014 published: Print ClinicalTrials.gov: NCT00876967 CommentIn: Eur J Anaesthesiol. 2013 Apr;30(4):139-41. - PMID 23471117 Citation Status MEDLINE |
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| doi: |
10.1097/EJA.0b013e32835c1cdb |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM223772313 |
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| 100 | 1 | |a Buléon, Clément |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of plastic and metallic single-use and metallic reusable laryngoscope blades |b a randomised controlled trial |
| 264 | 1 | |c 2013 | |
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| 500 | |a Date Completed 26.08.2013 | ||
| 500 | |a Date Revised 18.04.2014 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT00876967 | ||
| 500 | |a CommentIn: Eur J Anaesthesiol. 2013 Apr;30(4):139-41. - PMID 23471117 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a CONTEXT: Plastic single-use laryngoscope blades have been found to increase the difficulty of intubation. Metallic single-use blades may represent an alternative | ||
| 520 | |a OBJECTIVE: To compare the rates of intubation failure at first laryngoscopy using metallic single-use, plastic single-use and metallic reusable laryngoscope blades | ||
| 520 | |a DESIGN: Randomised, superiority, single-centre, controlled trial | ||
| 520 | |a SETTING: Operating theatres at a University Hospital from January 2008 to August 2009 | ||
| 520 | |a PATIENTS: A total of 1863 adults requiring general anaesthesia | ||
| 520 | |a INTERVENTION: Patients were randomised to one of three laryngoscope blades: metallic single-use, plastic single-use or metallic reusable | ||
| 520 | |a MAIN OUTCOME MEASURE: The primary end-point was the number of intubation failures at first laryngoscopy. Secondary end-points were glottic exposure and the Intubation Difficulty Scale | ||
| 520 | |a RESULTS: The failure rate (absolute difference: 95% confidence interval) at the first attempt was greater for the plastic single-use blades (8.1%) than for the metallic reusable [3.2% (4.9%: 2.2 to 7.6%); P < 0.001] and metallic reusable blades [4.0% (4.0%: 1.2 to 6.9%); P < 0.006]. No difference was found between the metallic reusable and metallic single-use groups (0.9%: -1.3 to 3.1%). Scoring on the Intubation Difficulty Scale [median (interquartile range)] was higher in the plastic single-use group [1 (0 to 2)] than in the metallic groups [metallic reusable: 0 (0 to 1); P < 0.001 and metallic single-use: 0 (0 to 1); P < 0.007] groups. Glottic exposure was significantly better in the metallic reusable group (modified Cormack & Lehane score III and IV: 3.7%) compared with the plastic single-use group (modified Cormack & Lehane score III and IV: 9.4%; P < 0.03) | ||
| 520 | |a CONCLUSION: The rates of failed intubation at first laryngoscopy were similar in the metallic reusable and metallic reusable groups, but greater in the plastic single-use group | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Metals |2 NLM | |
| 650 | 7 | |a Plastics |2 NLM | |
| 700 | 1 | |a Parienti, Jean-Jacques |e verfasserin |4 aut | |
| 700 | 1 | |a Lesage, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Grandin, Wilfried |e verfasserin |4 aut | |
| 700 | 1 | |a Pouliquen, Emmanuel |e verfasserin |4 aut | |
| 700 | 1 | |a Flais, Frédéric |e verfasserin |4 aut | |
| 700 | 1 | |a Simonet, Thérèse |e verfasserin |4 aut | |
| 700 | 1 | |a Gérard, Jean-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Hanouz, Jean-Luc |e verfasserin |4 aut | |
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