A randomised controlled trial comparing video laryngoscopy versus conventional blind technique for transoesophageal echocardiography probe insertion in paediatric patients undergoing cardiac surgery: A pilot study.

Abstract

Background and aims: Inserting a transoesophageal echocardiography (TEE) probe can cause pharyngeal and oesophageal injuries in paediatric patients undergoing cardiac surgery. The study's primary objective was to assess the incidence of oropharyngeal injury on video laryngoscope (VL) examination at the end of surgery.

Methods: This randomised controlled study was conducted on 100 patients, aged 2-10 years, undergoing elective cardiac surgery requiring TEE evaluation. Patients having a deranged coagulation profile, sore throat, difficult tracheal intubation, trauma during tracheal intubation and contraindications for TEE insertion were excluded from the study. Patients were randomised into the conventional group (Group C; n = 50), where the TEE probe was inserted using the conventional blind insertion technique, and the VL group (Group VL; n = 50). All patients were examined with VL for oropharyngeal injury after removal of the TEE probe at the completion of surgery, and the injury site was documented.

Results: The incidence of pharyngeal mucosal injury was significantly lesser in Group VL (n = 2) than in the Group C (n = 9) (P = 0.025). The number of attempts for successful TEE probe insertion was significantly lower in Group VL (P < 0.05). The mean duration for successful TEE probe insertion at the first attempt was significantly longer in Group VL than in Group C (P < 0.0001).

Conclusion: The use of VL for TEE probe insertion in paediatric patients significantly reduced the incidence of pharyngeal injury related to its insertion and provided direct visualisation of the oesophageal inlet.