Evidence map›Paper›PMID 33066735›Full record

Trial reportBMC anesthesiology2020

The skill of tracheal intubation with rigid scopes - a randomised controlled trial comparing learning curves in 740 intubations.

Lorenz Theiler, Robert Greif, Lukas Bütikofer, Kristopher Arheart, Maren Kleine-Brueggeney

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 3 countries.

Lorenz TheilerDepartment of Anaesthesia, Cantonal Hospital Aarau, Aarau, Switzerland.
Robert GreifDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Lukas BütikoferCTU Bern, University of Bern, Bern, Switzerland.
Kristopher ArheartDepartment of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Maren Kleine-BrueggeneyDepartment of Anaesthesia, University Children's Hospital Zurich - Eleonore Foundation and University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. maren.kleinebrueggeney@gmail.com.ORCID 0000-0002-5595-8529
Kantonsspital Aarau · CHSigmund Freud Privatuniversität Wien · ATUniversity of Bern · CHUniversity of Miami · USUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRigid scopes are successfully used for management of difficult airways, but learning curves have not been established.

methodsThis randomised controlled trial was performed at the University Hospital Bern in Switzerland to establish learning curves for the rigid scopes Bonfils and SensaScope and to assess their performance. Fifteen consultant anaesthetists and 15 anaesthesia registrars performed a total of 740 intubations (10 to 20 intubations with each device per physician) in adult patients without predictors of a difficult airway under general anaesthesia. According to randomisation, physicians intubated the patient's trachea with either the Bonfils or the SensaScope. A maximum of three intubation attempts was allowed. Primary outcome was overall time to successful intubation. Secondary outcome parameters included first attempt success, first attempt success within 60 s, failures and adverse events.

resultsA clear learning effect was demonstrated: Over 20 trials, intubations became 2.5-times quicker and first attempt intubation success probability increased by 21-28 percentage points. Fourteen and 20 trials were needed with the Bonfils and the SensaScope, respectively, to reach a 90% first attempt success probability. Intubation times were 23% longer (geometric mean ratio 1.23, 95% confidence interval 1.12-1.36, p < 0.001) and first attempt success was less likely (odds ratio 0.64, 95% confidence interval 0.45-0.92, p = 0.016) with the SensaScope. Consultants showed a tendency for a better first attempt success compared to registrars. Overall, 23 intubations (10 Bonfils, 13 SensaScope) failed. Adverse events were rare and did not differ between devices.

conclusionsA clear learning effect was demonstrated for both rigid scopes. Fourteen intubations with the Bonfils and 20 intubations with the SensaScope were required to reach a 90% first attempt success probability. Learning of the technique seemed more complex with the SensaScope compared to the Bonfils.

trial registrationCurrent Controlled Trials, ISRCTN14429285 . Registered 28 September 2011, retrospectively registered.

Indexed as

Learning CurveAdolescentAdultAgedAged, 80 and overFemaleFiber Optic TechnologyHumansIntubation, IntratrachealLaryngoscopesMaleMiddle AgedYoung AdultDifficult airway managementLearning curvesProcedural skillsRigid scopesTracheal intubation

Identifiers

PMID33066735
PMCPMC7565755
OpenAlexW3092668190

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.