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Randomized Controlled Trial
. 2018 Sep 7;18(1):124.
doi: 10.1186/s12871-018-0592-7.

Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial

Youssef Ezhar  1 , Frederick D'Aragon  2   3 , Pablo Echave  1
Affiliations
Randomized Controlled Trial

Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial

Youssef Ezhar et al. BMC Anesthesiol. .

Abstract

Background: Direct laryngoscopy (DL) produce tachycardia and hypertension that could be fatal in a patient with a brain injury. Bonfils fiberscope and C-MAC videolaryngoscope are associated with little hemodynamic instability compared to DL. Scientific evidence comparing these two alternatives does not exist. We conducted this study to determine the hemodynamic effects of Bonfils compared to C-MAC in patients undergoing elective surgery.

Methods: Fifty (50) patients listed for elective surgery were randomly assigned to endotracheal intubation with Bonfils or C-MAC. After a standardized induction, intubation was done via the retromolar approach (Bonfils group) or via videolaryngoscopy (C-MAC group). A research assistant, who was not blinded to the intervention, recorded heart rate (HR) and arterial blood pressure (systolic, diastolic and mean arterial blood pressure [MAP]) at induction and at every minute during the 5 min post intubation. The primary outcome was the hemodynamic response to intubation, as verified every minute for the first 5 min compared to baseline value.

Results: After randomization, the two groups were comparable except for ASA I/II ratio which was slightly higher in the C-MAC group (p = 0.046). Heart rate (p = 0.40) and MAP (p = 0.30) were comparable between the two groups within 5 min post intubation. Intubation time was shorter with C-MAC than with Bonfils (30 ± 2 s vs 38 ± 2 s; p = 0.02).

Conclusion: Hemodynamic responses to tracheal intubation using the Bonfils fiberscope is comparable to the C-MAC videolaryngoscope among patients scheduled for an elective surgery. In light of these findings, using either technique appears to be a reasonable course of action.

Trial registration: ISRCTN #34923 , retrospectively registered, 26/03/2018.

Keywords: Bonfils; Endotracheal intubation; Videolaryngoscope.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Centre de recherche clinique Étienne-Le-Bel (project #14–111) and written informed consent was obtained from each participant.

Consent for publication

Participants consented to publication on the research consent form.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow Diagram
Fig. 2
Fig. 2
Heart rate during induction and intubation period. Data are expressed as mean ± SD. Bpm: beat per minute, min: minute
Fig. 3
Fig. 3
Mean heart rate variation during the post intubation period. Data are expressed as mean ± SD. Bpm: beat per minute, min: minute
Fig. 4
Fig. 4
Mean arterial pressure during induction and intubation period. Data are expressed as mean ± SD. Min: minute
Fig. 5
Fig. 5
Mean arterial pressure variation during the post intubation period. Data are expressed as mean ± SD. Min: minute
See this image and copyright information in PMC

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