Comparison of two different positions of an anaesthesiologist for ease of endotracheal intubation in adult patients: A randomised control trial

IF 3.7 3区医学 Q1 ANESTHESIOLOGY Anaesthesia Critical Care & Pain Medicine Pub Date : 2024-10-01 DOI:10.1016/j.accpm.2024.101422

Poonam Kumari, Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Kunal Singh

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Abstract

Background and aims

Maintaining the airway with a cuffed endotracheal tube (ETT) in the trachea remains one of the most essential anaesthesia skills. Many parameters were described to assess the difficulty of intubation in the preoperative period, but none allow the prediction of all difficult intubations. The correct posture of the anaesthesiologist is also an important factor for successful endotracheal intubation. The aim of this study was. This study aimed to compare the impact of two different positions of an anaesthesiologist (sitting vs. standing) at the time of endotracheal intubation.

Methods

One hundred ten American Society of Anaesthesiologists (ASA) Physical Status I/II patients, aged between 17 to 65 years, Mallampati grade I/II, mouth opening 39–70 mm, thyromental distance (TMD) 6–6.5 cm, and sternomental distance (SMD) >13 cm, scheduled for elective laparoscopic cholecystectomy, were recruited. Patients were divided into two groups; Group I consisted of patients who underwent endotracheal intubation by an anaesthesiologist in a sitting posture, while Group II encompassed patients who underwent endotracheal intubation by anaesthesiologists in a standing posture. Assessment parameters include ease of intubation (IDS score), intubation time, intubation success rate, number of attempts, grade of laryngoscopy (Cormack Lehane score, POGO score), and complications like tooth and soft tissue damage.

Results

The ease of intubation was higher in group I, 1(0–1), than in group II, 1(1−2) (p = 0.02), and there was a significant difference between the two groups. The Cormack Lehane grade (CL) was I/IIa/IIb/III in 19/23/13/0 in group I and I/IIa/IIb/III in 13/21/18/3 in group II. The first-attempt intubation success rate for groups I and II was 94.54 % and 92.72 % respectively.

Conclusion

The sitting posture of an anaesthesiologist at the time of laryngoscopy provides a better intubating condition when compared with the standing posture.

Registration

Clinical Trial Registry - India (CTRI) CTRI/2023/03/050371.

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比较麻醉师的两种不同体位对成年患者气管插管的易用性：随机对照试验。

背景和目的：在气管内使用带袖带的气管导管（ETT）保持气道通畅仍然是最基本的麻醉技能之一。许多参数被用来评估术前插管的难度，但没有一个参数可以预测所有困难插管。麻醉师的正确姿势也是成功进行气管插管的重要因素。本研究的目的是本研究旨在比较麻醉医师在气管插管时两种不同姿势（坐姿与站姿）的影响：方法：招募了 110 名美国麻醉医师协会（ASA）身体状况 I/II 级患者，年龄在 17 至 65 岁之间，Mallampati I/II 级，张口 39 至 70 毫米，甲状腺距离（TMD）6 至 6.5 厘米，胸骨距离（SMD）大于 13 厘米，计划进行择期腹腔镜胆囊切除术。患者被分为两组，第一组包括由麻醉师以坐姿进行气管插管的患者，第二组包括由麻醉师以站立姿势进行气管插管的患者。评估参数包括插管难易程度（IDS 评分）、插管时间、插管成功率、尝试次数、喉镜检查等级（Cormack Lehane 评分、POGO 评分）以及牙齿和软组织损伤等并发症：结果：第一组（1（0-1））的插管难易度高于第二组（1（1-2））（P = 0.02），两组之间存在显著差异。I 组中 19/23/13/0 的 Cormack Lehane 分级（CL）为 I/IIa/IIb/III，II 组中 13/21/18/3 的 Cormack Lehane 分级（CL）为 I/IIa/IIb/III。第一组和第二组的首次尝试插管成功率分别为 94.54 % 和 92.72 %：结论：与站立姿势相比，麻醉医生在喉镜检查时的坐姿能提供更好的插管条件：注册：印度临床试验注册中心（CTRI）CTRI/2023/03/050371。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.