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A randomised controlled trial comparing video laryngoscopy versus conventional blind technique for transoesophageal

Guriqbal Singh1, Jigisha Pujara1, Ankit Chauhan1

  • 1Department of Cardiac Anaesthesia, U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India.

Indian Journal of Anaesthesia
|March 31, 2025
PubMed

Insights

Video laryngoscope (VL) use during transesophageal echocardiography (TEE) probe insertion in pediatric cardiac surgery patients significantly reduced pharyngeal injuries. This method also decreased the number of attempts needed for successful TEE probe placement.

Area of Science:

  • Pediatric Cardiac Surgery
  • Anesthesiology
  • Medical Devices

Background:

  • Transesophageal echocardiography (TEE) probe insertion can lead to pharyngeal and esophageal injuries in pediatric patients undergoing cardiac surgery.
  • Oropharyngeal injury assessment is crucial after TEE probe placement.

Purpose of the Study:

  • To assess the incidence of oropharyngeal injury using video laryngoscope (VL) examination after TEE probe insertion in pediatric cardiac surgery patients.
  • To compare the safety and efficacy of VL-guided TEE probe insertion versus conventional blind insertion.

Main Methods:

  • A randomized controlled study involving 100 pediatric patients (aged 2-10 years) undergoing elective cardiac surgery requiring TEE.
  • Patients were randomized into two groups: conventional blind insertion (Group C, n=50) and VL-guided insertion (Group VL, n=50).
  • Oropharyngeal injury was assessed using VL after TEE probe removal; injury site documentation was performed.

Main Results:

  • The incidence of pharyngeal mucosal injury was significantly lower in the VL group (2/50) compared to the conventional group (9/50) (P=0.025).
  • The number of attempts for successful TEE probe insertion was significantly lower in the VL group (P<0.05).
  • The mean duration for successful TEE probe insertion at the first attempt was significantly longer in the VL group (P<0.0001).

Conclusions:

  • Video laryngoscope (VL) use for TEE probe insertion in pediatric patients significantly reduces pharyngeal injury incidence.
  • VL provides direct visualization of the esophageal inlet, improving safety during TEE probe placement.
  • VL-guided insertion may be a safer alternative to conventional blind insertion for TEE in pediatric cardiac surgery.
Abstract

Keywords:
Cardiac surgeryTEElaryngoscopyoesophageal injuryorophrayngeal injurypaediatrictransoesophageal echocardiographyvideo laryngoscope

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