title: Fibreoptic intubation through the laryngeal mask airway: effect of operator experience*.
abstract: In a randomised crossover study, we compared times and success rates for tracheal placement of a fibrescope and railroading of a tracheal tube through the classic laryngeal mask airway by anaesthetists with limited experience in fibreoptic intubation (trainees) and those who were experts. Thirty-two patients, 32 trainees and three experts took part. The median (IQR [range]) times to fibrescope placement for trainees and experts were 21 (18-30 [12-58]) s and 17 (14-24 [9-55]) s, respectively (95% CI for the difference 2-8 s; p = 0.023). There were no significant differences between trainees and experts in the times to placement of the laryngeal mask airway (41 (33-47 [31-105]) s and 36 (33-43 [30-52]) s, respectively; p = 0.24), railroading times (43 (40-58 [33-87]) s and 44 (38-57 [31-83]) s, respectively; p = 0.96) and total intubation time (114 (97-127 [80-213]) s and 95 (89-116 [74-139]) s, respectively; p = 0.13). There was no significant difference in the number of attempts needed for successful placement of the fibrescope (p = 0.12) and railroading the tracheal tube (p = 0.22). The differences between experts and trainees when using fibrescope assisted intubation via the classic laryngeal mask airway were not clinically important.
authors.affiliation: Department of Anaesthetics and Intensive Care Medicine, Cardiff University, Cardiff, UK. Hodzovic@cf.ac.uk
authors.forename: I
authors.initials: I
authors.lastname: Hodzovic
authors.forename: C
authors.initials: C
authors.lastname: Janakiraman
authors.forename: G
authors.initials: G
authors.lastname: Sudhir
authors.forename: N
authors.initials: N
authors.lastname: Goodwin
authors.forename: A R
authors.initials: AR
authors.lastname: Wilkes
authors.forename: I P
authors.initials: IP
authors.lastname: Latto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D018592:Cross-Over Studies; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D017214:Laryngeal Masks; D007828:Laryngoscopy; D008505:Medical Staff, Hospital / Q000592:standards; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult