A randomized controlled trial comparing SaCoVLMTM video laryngeal mask airway-guided intubation with Am-bu?Aura-Gain laryngeal mask airway combined with fiberoptic bronchoscopy-guided intubation in children
Objective To explore the clinical effect of SaCoVLMTM video laryngeal mask airway and Ambu®Aura-Gain laryn-geal mask airway combined with fiberoptic bronchoscopy(FOB)for airway management in children under general anesthesia.Meth-ods According to the random number table method,100 patients aged 1-6 years,classified as American Society of Anesthesiologists physical status(ASA)Ⅰ or Ⅱ and Mallampati grade Ⅰ or Ⅱ,were divided into two groups(n=50):the SaCoVLMTM laryngeal mask airway-guided intubation group(SaCo group)and the Ambu®Aura-Gain combined with FOB group(Ambu group).In the SaCo group,tracheal intubation was performed directly under the guidance of video laryngeal mask airway.In the Ambu group,tracheal intubation was guided by Ambu®Aura-Gain laryngeal mask airway combined with FOB.General data of two groups were recorded.Primary out-come is the total time to successful tracheal intubation.Secondary outcomes include the first-attempt success rate of intubation,time of laryngeal mask insertion,number of laryngeal mask insertion,leakage pressure,time of intubation,glottis exposure grade,the hemody-namic variables[at admission to the operating room(T0),before laryngeal mask airway insertion(T1),immediately after laryngeal mask airway insertion(T2),before intubation(T3),1 minute after intubation(T4),2 minutes after intubation(T5),5 minutes after intubation(T6),and after extubation(T7)],the retention time of laryngeal mask airway,extubation time,and complications associated with larynge-al mask placement and tracheal intubation(including laryngeal mask airway and tracheal tube surface blood staining,choking,hypox-emia,sore throat,laryngospasm,dysphagia,hoarseness,etc).Results There was no significant difference in general data between the two groups(all P＞0.05).Compared with the Ambu group,the SaCo group had shorter the total time of successful tracheal intubation and the time of intubation(all P＜0.05),a higher first-attempt success rate of intubation and a higher leakage pressure(P＜0.05),a lon-ger time for laryngeal mask airway insertion(P＜0.05)and a lower heart rate at T4(P＜0.05).Laryngeal mask airway was successfully in-serted in children at one time.There were no significant differences in the glottis exposure grade,the time of laryngeal mask insertion and extubation time between the two groups(all P＞0.05).There was no significant difference in heart rate at T0-T3 and T5-T7,mean arterial pressure and pulse oxygen saturation at each time point between the two groups(all P＞0.05).After the laryngeal mask airway was removed,there was no significant difference in the incidence of blood staining on the laryngeal mask surface and sore throat be-tween the two groups(all P＞0.05).There were no related complications such as tracheal tube surface blood staining,choking,laryngo-spasm,hypoxemia,dysphagia,and hoarseness in both groups.Conclusions Compared with the Ambu®Aura-Gain laryngeal mask airway combined with FOB,the SaCoVLMTM video laryngeal mask airway is easier to use and has a higher first-attempt success rate of intubation.It may provide a better solution for managing difficult airway in children.
ChildrenSaCoVLMTM video laryngeal mask airwayAmbu®Aura-Gain laryngeal mask airwayTracheal intu-bationAirway management
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