• Br J Anaesth · Sep 2016

    Randomized Controlled Trial

    Use of deep laryngeal oxygen insufflation during laryngoscopy in children: a randomized clinical trial.

    • J W Steiner, D I Sessler, N Makarova, E J Mascha, P N Olomu, J W Zhong, C T Setiawan, A E Handy, B N Kravitz, and P Szmuk.
    • Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Centre and Children's Health, 1935 Medical District Drive, Dallas, TX 75235, USA Outcomes Research Consortium, Cleveland, OH, USA jeffrey.steiner@utsouthwestern.edu.
    • Br J Anaesth. 2016 Sep 1; 117 (3): 350-7.

    BackgroundBrief periods of haemoglobin oxygen desaturation are common in children during induction of general anaesthesia. We tested the hypothesis that oxygen insufflation during intubation slows desaturation.MethodsPatients 1-17 yr old undergoing nasotracheal intubation were enrolled and randomly assigned to one of three groups: standard direct laryngoscopy (DL); laryngoscopy with Truview PCD videolaryngoscope (VLO2); or laryngoscopy with an oxygen cannula attached to the side of a standard laryngoscope (DLO2). The co-primary outcomes were time to 1% reduction in [Formula: see text] from baseline, and the slope of overall desaturation vs time. All three groups were compared against each other.ResultsData from 457 patients were available for the final analysis: 159 (35%) DL; 145 (32%) DLO2; and 153 (33%) VLO2. Both VLO2 and DLO2 were superior to DL in both time to a 1% reduction in [Formula: see text] from baseline and the overall rate of desaturation (all P<0.001). The 25th percentile (95% confidence interval) of time to a 1% saturation decrease was 30 (24, 39) s for DL, 67 (35, 149) s for DLO2 and 75 (37, 122) s for VLO2. Mean desaturation slope was 0.13 (0.11, 0.15)% s(-1) for DL, 0.04 (0.02, 0.06)% s(-1) for DLO2 and 0.03 (0.004, 0.05)% s(-1) for VLO2. We did not find a correlation between decrease in [Formula: see text] percentage and BMI or age.ConclusionsLaryngeal oxygen insufflation increases the time to 1% desaturation and reduces the overall rate of desaturation during laryngoscopy in children.Clinical Trial RegistrationNCT01886807.© The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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