Pediatric anesthesia & critical care
Comparison of Spontaneous Breathing Versus Paralyzed Technique During Flexible Bronchoscopic Intubation in Anesthetized Children and Adolescents With Temporomandibular Joint Ankylosis: Randomized Parallel Group Trial
Primary resultResult — go to the resultRelative risk 0.06 95% CI 0.01–0.39Authors' conclusion
Paralyzed technique is associated with lower incidence of difficult flexible bronchoscopic intubation compared to spontaneously breathing technique in children and adolescents with temporomandibular joint ankylosis.
Study context
- Population
- Children and adolescents up to 18 years with temporomandibular joint ankylosis and mouth opening < 1.5 cm scheduled for elective surgery
- Participants
- 70 children
- Comparison
- Group P vs group S
- Primary endpoint
- Incidence of difficult flexible bronchoscopic intubation
Methodological detailsparallel group
- Parallel group
Primary result
As reported in the abstract
Relative risk
0.06
95% CI 0.01–0.39
P < 0.001
Events by treatment group
Group P vs group S
RR 0.06 (95% CI 0.01–0.39); P < 0.001
Secondary outcomes
| Outcome | Median difference (sec) (CI) | P value | |
|---|---|---|---|
| Time to visualize the glottisLower in paralyzed group | 30 (24–36) | P < 0.001 | |
| Time to the carinaLower in paralyzed group | 62 (29–94) | P = 0.001 | |
| Time to intubationLower in paralyzed group | 97 (59–135) | P = 0.003 | |
| −1000100200Difference, sec (linear scale) |
| Outcome | Difference (CI) | P value | |
|---|---|---|---|
| Vocal cord closure | −20% (−33.3% to −6.7%) | P = 0.005 | |
| Blood in the bronchoscopy field | −28.6% (−44.9% to −12.2%) | P = 0.002 | |
| −60−40−20020Difference (linear scale) |
Coughing, hemodynamic response to intubation
- Comparable between the groups
Safety
| Outcome | Difference (CI) | P value | |
|---|---|---|---|
| Desaturation | −14.3% (−27.9% to −0.63%) | P = 0.04 | |
| −40−20020Difference (linear scale) |
Postoperative sore throat
- Comparable between the groups
Original publication
Comparison of Spontaneous Breathing Versus Paralyzed Technique During Flexible Bronchoscopic Intubation in Anesthetized Children and Adolescents With Temporomandibular Joint Ankylosis: Randomized Parallel Group Trial. Paediatr Anaesth. Published 9 June 2025. doi:10.
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