Monday June 25, 2007
Regarding disposable plastic laryngoscope blade


Is disposable plastic laryngoscope blade acceptable ?


Answer is "No".
To save money and in some cases to decrease infection rate, there has been temptation in many institutions to use disposable plastic laryngoscope blade.

One study recently published from france 1 in which 284 adult patients requiring rapid sequence induction (for intubation) were randomly assigned to either plastic single-use or reusable metal blades.

In the case of failed intubation, a second attempt was performed using metal blade.

The primary endpoint of the study was the rate of failed intubations.
The secondary endpoint was the incidence of complications (oxygen desaturation, lung aspiration, and oropharynx trauma).

Results:

• On the first attempt, the rate of failed intubation was significantly increased in plastic blade group (17 vs. 3%).
• In plastic blade group, all initial failed intubations were successfully intubated using metal blade, but in metal blade group, 50% of failed intubations were still difficult after the second attempt.
• There was a significant increase in the complication rate in plastic group (15 vs. 6%).

Study concluded that in rapid sequence induction of anesthesia, the plastic laryngoscope blade should not be recommended for use.


Editors' note: Possible reasons of poor outcome from plastic blades include uneven curvatures, poor allignment or fitting with laryngoscope and chances of breaking down durin procedure.




References: click to get article

Comparison of Plastic Single-use and Metal Reusable Laryngoscope Blades for Orotracheal Intubation during Rapid Sequence Induction of Anesthesia. - Anesthesiology. 104(1):60-64, January 2006.