scholarly journals Usefulness of Airway Scope for intubation of infants with cleft lip and palate–comparison with Macintosh laryngoscope: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yoko Okumura ◽  
Masahiro Okuda ◽  
Aiji Sato Boku ◽  
Naoko Tachi ◽  
Mayumi Hashimoto ◽  
...  
2019 ◽  
Author(s):  
Yoko Okumura ◽  
Masahiro Okuda ◽  
Aiji Sato (Boku) ◽  
Naoko Tachi ◽  
Mayumi Hashimoto ◽  
...  

Abstract Background: Airway Scope (AWS) with its plastic blade does not require a head-tilt or separate laryngoscopy to guide intubations. Therefore, we hypothesized that its use would reduce the intubation time (IT) and the frequency of airway complication events when compared with the use of Macintosh Laryngoscope (ML) for infants with cleft lip and palate (CLP). Methods: The parents of all patients provided written consents; we enrolled 40 infants with CLP (ASA-PS 1). After inducing general anesthesia using sevoflurane and rocuronium, we performed orotracheal intubations using either AWS (n = 20) or ML (n = 20), randomly. We define the duration between manual manipulation using cross finger for maximum mouth opening and the first raising motion of the chest following intubation by artificial ventilation as “IT;” further, the measured IT as primary outcomes. Airway complications were considered secondary outcomes. Moreover, we looked for associations between IT and the patient’s characteristics: extensive clefts, age, height, and weight. We used the Mann–Whitney test and Fisher’s exact probability test for statistical analysis; p < 0.05 was considered as statistically significant. Results: The mean IT was 31.5 ± 8.3 s in AWS group and 26.4 ± 8.9 seconds in ML group. Statistical significant difference was not found in IT between the two groups. The IT of AWS group was statistically related to extensive clefts. Airway complications were detected in ML group. Conclusion: AWS is useful for intubation of infants with CLP; it required IT similar to that required using ML, with a lower rate of airway complications. Trial Registration UMIN-CTR Registration number UMIN000024763 Registered 8 November 2016 Keywords: Airway Scope, Macintosh Laryngoscope, infant, intubation time


2018 ◽  
Author(s):  
Yoko Okumura ◽  
Masahiro Okuda ◽  
Aiji Sato (Boku) ◽  
Naoko Tachi ◽  
Mayumi Hashimoto ◽  
...  

Abstract Background: Airway Scope (AWS) with its plastic blade does not require a head-tilt or separate laryngoscopy to guide intubations. Therefore, we hypothesized that its use would reduce the intubation time (IT) and the frequency of airway complication events when compared with the use of Macintosh Laryngoscope (ML) for infants with cleft lip and palate (CLP). Methods: The parents of all patients provided written consents; we enrolled 40 infants with CLP (ASA-PS 1). After inducing general anesthesia using sevoflurane and rocuronium, we performed orotracheal intubations using either AWS (n = 20) or ML (n = 20), randomly. We define the duration between manual manipulation using cross finger for maximum mouth opening and the first raising motion of the chest following intubation by artificial ventilation as “IT;” further, the measured IT as primary outcomes. Airway complications were considered secondary outcomes. Moreover, we looked for associations between IT and the patient’s characteristics: extensive clefts, age, height, and weight. We used the Mann–Whitney test and Fisher’s exact probability test for statistical analysis; p < 0.05 was considered as statistically significant. Results: The mean IT was 31.5 ± 8.3 s in AWS group and 26.4 ± 8.9 seconds in ML group. Statistical significant difference was not found in IT between the two groups. The IT of AWS group was statistically related to extensive clefts. Airway complications were detected in ML group. Conclusion: AWS is useful for intubation of infants with CLP; it required IT similar to that required using ML, with a lower rate of airway complications. Trial Registration UMIN-CTR Registration number UMIN000024763 Registered 8 November 2016 Keywords: Airway Scope, Macintosh Laryngoscope, infant, intubation time


2020 ◽  
Vol 57 (12) ◽  
pp. 1382-1391
Author(s):  
Mohamed Abd El-Ghafour ◽  
Mamdouh A. Aboulhassan ◽  
Amr Ragab El-Beialy ◽  
Mona M. Salah Fayed ◽  
Faten Hussein Kamel Eid ◽  
...  

Objective: The aim of the current randomized controlled trial (RCT) was to assess the effectiveness of taping alone in changing the maxillary arch dimensions (MADs) in infants with unilateral complete cleft lip and palate (UCLP) before surgical lip repair. Design: A prospective, balanced, randomized, parallel-group, single-blinded, controlled trial. Setting: All the steps of the current study were carried in the Department of Orthodontics, Cairo University in Egypt. Participants: Thirty-one, nonsyndromic infants with UCLP. Interventions: The eligible infants were randomly assigned to either no-treatment (control) or taping groups. In the taping group, all the infants received horizontal tape between the 2 labial segments aiming to decrease the cleft gap. No other interventions were performed to infants included in this group. Rubber base impressions were made to all the included infants in both groups at the beginning of the treatment (T1) and directly before surgical lip repair (T2). All the produced models were scanned using a desktop scanner producing digital models for outcome assessment. Main Outcomes Measures: A blinded assessor carried out all the MAD measurements virtually on the produced digital models at the beginning (T1) and after (T2) treatment. Results: Clinically and/or statistically significant changes in all the measured MADs were recorded in the taping group at T2 before surgical lip repair in comparison to the control group. Conclusions: It seems that taping alone is an efficient tool in changing the MADs before surgical lip repair in infants with UCLP.


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