Glidescope versus laringoscopía convencional para intubación endotraqueal en pacientes con obesidad morbida en cirugías programadas Hospital Dr. Teodoro Maldonado Carbo 2016 - 2017
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La vía aérea permeable es y seguirá siendo la principal preocupación del acto anestésico-quirúrgico por parte del anestesiólogo, siendo la responsabilidad principal proporcionar al paciente una ventilación adecuada. La vía aérea difícil es una situación en la que el anestesiólogo convencionalmente entrenado experimenta dificultad con la ventilación o con las intubaciones traqueales, situación muy frecuente que se presentan en pacientes obesos. El presente estudio tuvo como objetivo determinar la eficacia del glidescope versus laringoscopia convencional para intubación endotraqueal en pacientes con obesidad mórbida en cirugías programada en el Hospital Dr. Teodoro Maldonado Carbo, durante el 2016- 2017. Se realizó un estudio observacional, aleatorio, descriptivo, comparativo, no experimental, transversal y prospectivo donde se incluyeron 100 pacientes distribuidos en dos grupos de 50 cada uno, entre 18-65 años, de ambos sexos programados para cirugías bajo anestesia general balanceada, los pacientes del Grupo A fueron intubados con Glidescope y los del Grupo B con laringoscopia convencional (Macintosh). Se comprobó que la utilización del Glidescope ofrece una mayor tasa de éxito de intubación orotraqueal del 98% en pacientes obesos mórbidos con signos de intubación difícil durante la inducción anestésica; a diferencia de la intubación con laringoscopio Macintosh que tuvo una menor tasa de éxito del 88%, además la duración promedio para la intubación orotraqueal fue menor para el grupo de Glidescope (40 ± 5 seg) contra (60 ± 10 seg) de intubación con Macintosh. Las complicaciones como laceraciones bucales fueron estadísticamente iguales en ambos grupos. En conclusión la mejor técnica para intubación endotraqueal en pacientes con obesidad mórbida es el Glidescope.
The permeable airway is and will continue to be the main concern of the anesthesia-surgical procedure by the anesthesiologist, with the main responsibility being to provide the patient with adequate ventilation. The difficult airway is a situation in which the conventionally trained anesthesiologist experiences difficulty with ventilation or with tracheal intubations, a very frequent situation that occur in obese patients. The present study aimed to determine the efficacy of glidescope versus conventional laryngoscopy for endotracheal intubation in patients with morbid obesity at surgeries scheduled at Dr. Teodoro Maldonado Carbo Hospital during 2016-2017.An observational, randomized, descriptive, comparative, non-experimental, cross-sectional and prospective study was performed, including 100 patients divided into two groups of 50 each, aged 18-65 years, of both sexes scheduled for surgeries under general anesthesia, Group A patients were intubated with Glidescope and Group B patients with conventional laryngoscopy (Macintosh). We observed that the use of Glidescope offers a greater success rate of orotracheal intubation of 98% in morbidly obese patients with signs of difficult intubation during anesthetic induction; In contrast to intubation with Macintosh laryngoscope, which had a lower success rate of 88%, and the mean duration for orotracheal intubation was lower for the Glidescope group (40 ± 5 sec) versus (60 ± 10 sec) intubation with Macintosh. Complications such as lacerations of the mouth were statistically equal in both groups. In conclusion, the best technique for endotracheal intubation in patients with morbid obesity is Glidescope.
The permeable airway is and will continue to be the main concern of the anesthesia-surgical procedure by the anesthesiologist, with the main responsibility being to provide the patient with adequate ventilation. The difficult airway is a situation in which the conventionally trained anesthesiologist experiences difficulty with ventilation or with tracheal intubations, a very frequent situation that occur in obese patients. The present study aimed to determine the efficacy of glidescope versus conventional laryngoscopy for endotracheal intubation in patients with morbid obesity at surgeries scheduled at Dr. Teodoro Maldonado Carbo Hospital during 2016-2017.An observational, randomized, descriptive, comparative, non-experimental, cross-sectional and prospective study was performed, including 100 patients divided into two groups of 50 each, aged 18-65 years, of both sexes scheduled for surgeries under general anesthesia, Group A patients were intubated with Glidescope and Group B patients with conventional laryngoscopy (Macintosh). We observed that the use of Glidescope offers a greater success rate of orotracheal intubation of 98% in morbidly obese patients with signs of difficult intubation during anesthetic induction; In contrast to intubation with Macintosh laryngoscope, which had a lower success rate of 88%, and the mean duration for orotracheal intubation was lower for the Glidescope group (40 ± 5 sec) versus (60 ± 10 sec) intubation with Macintosh. Complications such as lacerations of the mouth were statistically equal in both groups. In conclusion, the best technique for endotracheal intubation in patients with morbid obesity is Glidescope.
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Glidescope, Laringoscopia, Intubación intratraqueal, Obesidad mórbidad, Epidemiología descriptiva, Estudio comparativo, Estudios prospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador