A Feasibility Study Using the VivaSight Single Lumen (TM) to Intubate the Trachea Through the Fastrach Laryngeal Mask Airway: A Preliminary Report of 50 Cases

作者：Gaitini Luis A^*; Yanovski Boris; Mustafa Somri; Hagberg Carin A; Charco Mora Pedro; Vaida Sonia J

来源：Anesthesia and Analgesia, 2013, 116(3): 604-608.

DOI：10.1213/ANE.0b013e31827b278f

BACKGROUND: The VivaSight Single Lumen (TM) (SL) is new endotracheal tube with a video camera and a light source in the tip allowing continuous visual observation of the airway. In this study, we checked the feasibility of endotracheal intubation with a VivaSight-SL through the Fastrach Laryngeal Mask Airway (R) (FT-LMA).
METHODS: We studied 50 patients with normal airways, scheduled for elective surgery during general anesthesia requiring endotracheal intubation. The FT-LMA was inserted and once adequate ventilation was achieved; the VivaSight-SL was passed through the FT-LMA into the trachea under visual control. The following criteria were used to score the laryngeal view: grade 1: full view of the arytenoids and glottis; grade 2: epiglottis, arytenoids or glottic opening are partly visible, the structure of cords is difficult to see; grade 3: dark areas indicating an open space; and grade 4: no part of the larynx can be identified.
RESULTS: The FT-LMA was placed successfully in 49 patients at the first attempt. One patient was excluded from the study after 2 failed attempts to ventilate with the FT-LMA. All 49 patients were successfully intubated with the VivaSight-SL, (95% confidence interval [CI] 0.89-0.99), 47 patients at the first attempt (95% CI, 0.83-0.98) and 2 patients at the second attempt. (95% CI, 0.004-0.13). The time to achieve an effective airway with the FT-LMA was 15.4 +/- 6 (mean +/- SD) seconds. The time to achieve a laryngeal view with the VivaSight-SL was 28.8 +/- 5 seconds. Correct position of the VivaSight-SL was confirmed with visualization of the carina. Time of successful intubation with VivaSight-SL from picking up the VivaSight-SL to observing a end-tidal CO2 curve was 45 +/- 7 seconds. After introducing the VivaSight-SL through the intubating channel of the FT-LMA, a grade 1 view was obtained in 18 patients, grade 2 in 18 patients, a grade 3 in 4 patients, and grade 4 in 9 patients.
CONCLUSION: The high first-attempt intubation success rate using the VivaSight-SL to intubate the trachea through a FT-LMA makes this technique an attractive and promising concept. (Anesth Analg 2013;116:604-8)

• 出版日期2013-3