Evidence map›Paper›PMID 33709262›Full record

Trial reportCanadian journal of anaesthesia = Journal canadien d'anesthesie2021

A randomized controlled trial comparing nociception level (NOL) index, blood pressure, and heart rate responses to direct laryngoscopy versus videolaryngoscopy for intubation: the NOLint project.

Virginie Sbeghen, Olivier Verdonck, Jason McDevitt, Valérie Zaphiratos, Véronique Brulotte, Christian Loubert, Issam Tanoubi, Pierre Drolet, Marie-Eve Belanger, Louis-Philippe Fortier and 4 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03277872 (NoL Index, Heart Rate and Mean Arterial Blood Pressure Responses to Tracheal Intubation Performed With MacIntosh Blade Versus Glidescope), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% 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.

NCT03277872 nacompletednot on this map

NoL Index, Heart Rate and Mean Arterial Blood Pressure Responses to Tracheal Intubation Performed With MacIntosh Blade Versus Glidescope

TypeinterventionalSponsorCiusss de L'Est de l'Île de MontréalRan2017 to 2021Enrolled50ConditionsIntubation, Nociceptive Pain, Anesthesia, LaryngoscopyArmsLaryngoscopy with GlideScope (GVL) Blade, Laryngoscopy with MacIntosh (MAC) Blade
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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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

14 authors at 1 institution in 1 country.

Virginie SbeghenDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Olivier VerdonckDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Jason McDevittDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Valérie ZaphiratosDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Véronique BrulotteDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Christian LoubertDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Issam TanoubiDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Pierre DroletDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Marie-Eve BelangerDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Louis-Philippe FortierDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Nadia GodinDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
Marie-Claude GuertinDepartment of Statistics, Montreal Health Innovations Coordinating Center (MHICC), Montréal, QC, Canada.
Annik FortierDepartment of Statistics, Montreal Health Innovations Coordinating Center (MHICC), Montréal, QC, Canada.
Philippe RichebéDepartment of Anesthesiology and Pain Medicine of University of Montreal, and the Department of Anesthesiology and Pain Medicine of Maisonneuve Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, University of Montreal, 5415, Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada. philippe.richebe@umontreal.ca.ORCID http://orcid.org/0000-0003-2808-9660
Hôpital Maisonneuve-Rosemont · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe effect of direct laryngoscopy using a Macintosh blade (MAC) vs GlideScope™ videolaryngoscopy using a Spectrum LoPro blade (GVL) on nociceptive stimulation has not been quantitatively studied. This study used the new nociception level (NOL) index to compare the nociceptive response induced by GVL or MAC during laryngoscopy with or without intubation.

methodsPatients underwent two laryngoscopies at four-minute intervals (L1, L2), one with GVL and the other with MAC (first randomization). A third laryngoscopy (L3) followed by tracheal intubation was performed four minutes after L2 (GVL or MAC, second randomization). Nociception was quantitatively assessed by NOL and standard hemodynamic parameters (heart rate [HR] and mean arterial pressure). For the crossover design, blade comparisons accounted for sequence and blade type. A possible carryover effect between laryngoscopies was assessed.

resultsIn the 50 patients randomized, there was no carryover effect from one laryngoscopy to the next for all analyzed parameters. Nociception level index peak values were higher with MAC than GVL. Analysis of ΔNOL showed a lower nociceptive response with GVL for L1+L2 combined. Mean peak NOL values were significantly higher after L3+intubation than after L1+L2, for both GVL and MAC groups. Analysis of ΔHR values did not show a significant difference between GVL and MAC for any laryngoscopy.

conclusionLaryngoscopy alone with GVL induces less nociception than with MAC. The NOL was more sensitive than HR at detecting nociceptive responses to MAC vs GVL. Additionally, and irrespective of which technique/blade was used, the combination of laryngoscopy + tracheal intubation produced a much greater nociceptive response than the laryngoscopy alone.

trial registrationwww.clinicaltrials.gov (NCT03277872); registered 29 August 2017.

Indexed as

LaryngoscopesLaryngoscopyBlood PressureHeart RateHumansIntubation, IntratrachealNociceptionGlideScope™ Spectrum™ angulated LoPro Single-Use BladeintubationlaryngoscopyMacintosh bladenociceptionNOL index

Identifiers

PMID33709262
OpenAlexW3134151530

What OpenQuestion holds

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Registered trials

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.