Revista Colombiana de Anestesiología
Print version ISSN 0120-3347
Objectives: To evaluate the efficacy, applicability and hemodynamic response to digital intubation on surgical patients in comparison to direct laryngoscopy to determine its usefullness at present time. Methods: This is a randomized controlled prospective trial involving 88 patients more than 12 years old for elective surgery in which general anesthesia with endotracheal intubation was required, excluding those who had indications for rapid sequence or direct vision intubation, those who were under effects of beta-adrenergic antagonists and calcium entry blockers. After standarized induction of anesthesia, each patient was ramdomly allocated to each of two groups: Digital intubation ID or Direct Laryngoscopy LD. Blood pressure and heart rate were recorded before during and after intubation procedure, as well as the time spent on the procedure. The ubication of tube was confirmed (by touch in group ID and by auscultation in group LD) and recorded. Results: There was not significative differences between average spent in intubation procedure in both groups[ID 28 seg. (15-70); LD 22 seg. (12-78), p=0,07] nor non detected esophagical intubation in any group; in ID group the procedure was aborted in 6 patients because of technical difficulties vs. 3 in the LD group. Digital confirmation method was a succesfull in all cases of ID. The arterial pressure and heart rate values had significative differences with respect to basal data [ID 15,9% y 4,6 vs. LD 63% y 34,1% respectively (P<0.001] without differences for the hemodynamic variables across the time between groups. No complications was derived from the procedures. Conclusion: Digital intubation technique is valid, even in adults and adolescent patients. Digital confirmation method of tube location is highly sensitive. It is important to keep in mind digital intubation, because in difficult cases we could have the solution in our hands.
Keywords : Digital intubation; endotracheal intubation; direct laryngoscopy.