• Br J Anaesth · Nov 2006

    Randomized Controlled Trial

    Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy.

    • G Dhonneur, S K Ndoko, A Yavchitz, A Foucrier, C Fessenmeyer, C Pollian, X Combes, and L Tual.
    • Department of Anaesthesia and Intensive Care, Jean Verdier University Hospital, 93143 Bondy, Cedex, Paris, France. gilles.dhonneur@jvr.aphp.fr
    • Br J Anaesth. 2006 Nov 1;97(5):742-5.

    BackgroundLMA CTrach (CT), a modified version of the intubating LMA Fastrach, allows continuous video-endoscopy of the tracheal intubation procedure. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway.MethodsAfter Ethics' Committee approval, 104 morbidly obese patients (BMI >35 kg m(-2)) scheduled for bariatric surgery were included in this prospective study. Patients were randomly assigned in two groups: tracheal intubation using direct laryngoscopy (DL) or the CT. Induction of anaesthesia was standardized using sufentanil, propofol and succinylcholine. Characteristics and consequences of airway management were evaluated.ResultsPreoperative characteristics of patients and consequences of anaesthesia induction on physiological variables were similar in both groups. Difficulty in facemask ventilation was similar in both groups. Tracheal intubation was successfully carried out with DL and CT. Forty-nine per cent of the patients from the CT group required laryngeal mask manipulation (ventilation and view optimization) resulting in increased duration of tracheal intubation by 57 s as compared with DL. Oxygenation was of better quality in the patients managed with CT than with DL. Blind tracheal intubation was mandatory in eight (17%) patients of the DL group, while tracheal intubation was seen in all patients of the CT group.ConclusionWe demonstrated that the CT was an efficient airway device for ventilation and tracheal intubation in case of a difficult airway in morbidly obese patients.

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