Cervical spine motion during flexible bronchoscopy compared with the Lo-Pro GlideScope.

نویسندگان

  • D M Wong
  • A Prabhu
  • S Chakraborty
  • G Tan
  • E M Massicotte
  • R Cooper
چکیده

BACKGROUND The most appropriate device for tracheal intubation in patients with potential cervical spine injury remains controversial. We hypothesized that the Lo-Pro GlideScope (LP-G) videolaryngoscope would not cause significantly greater cervical spine movement than fibreoptic bronchoscopy even in the non-immobilized spine. METHODS Twenty-eight healthy adults requiring intubation for radiographic procedures were randomized to either the LP-G or the flexible bronchoscope (FB) devices. Continuous fluoroscopy was used to assess cervical spine movement during tracheal intubation. The point of maximum movement was compared with baseline for change in angulation between Occiput (Occ)-C1, Occ-C2, Occ-C4, Occ-C5, C1-2, C2-4, and C4-5. Measurements were made by two independent observers. The change in angulation was also measured for tongue pull and jaw thrust, manoeuvres for enlarging the pharyngeal space, before FB intubation. RESULTS LP-G resulted in greater cervical extension compared with FB for every angle calculated, statistically significant between Occ-C1 (P<0.05), Occ-C2 (P<0.05), and Occ-C4 (P<0.01). Tongue pull resulted in significantly less cervical spine motion than FB intubation at Occ-C1, Occ-C2, Occ-C4, and Occ-C5 (P<0.05). When jaw thrust was added to tongue pull, there was a tendency for greater movement than FB intubation at Occ-C1, Occ-C2, and Occ-C3. This was statistically significant at Occ-C1 and Occ-C3 (P<0.05) for one of the two observers. CONCLUSIONS During intubation under general anaesthesia, LP-G resulted in greater cervical movement than FB when no cervical immobilization was used in adults without cervical disease. Airway manoeuvres performed before FB, especially jaw thrust, also resulted in cervical spine movement.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Comparison of the McGrath® Series 5 and GlideScope® Ranger with the Macintosh laryngoscope by paramedics

BACKGROUND Out-of-hospital endotracheal intubation performed by paramedics using the Macintosh blade for direct laryngoscopy is associated with a high incidence of complications. The novel technique of video laryngoscopy has been shown to improve glottic view and intubation success in the operating room. The aim of this study was to compare glottic view, time of intubation and success rate of t...

متن کامل

Comparison of intubation times using a manikin with an immobilized cervical spine: Macintosh laryngoscope vs. GlideScope vs. fiberoptic bronchoscope

OBJECTIVE Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF...

متن کامل

Airway management of patients with traumatic brain injury/C-spine injury

Traumatic brain injury (TBI) is usually combined with cervical spine (C-spine) injury. The possibility of C-spine injury is always considered when performing endotracheal intubation in these patients. Rapid sequence intubation is recommended with adequate sedative or analgesics and a muscle relaxant to prevent an increase in intracranial pressure during intubation in TBI patients. Normocapnia a...

متن کامل

Evaluation of the GlideScope for tracheal intubation in patients with cervical spine immobilisation by a semi-rigid collar.

Application of cervical collars may reduce cervical spine movements but render tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesised that despite the presence of a Philadelphia Patriot cervical collar and with the patient's head taped to the trolley, tracheal intubation would be possible in 50 adult patients using the GlideScope and its dedicated stylet. ...

متن کامل

Tips and Troubleshooting for Use of the GlideScope Video Laryngoscope for Emergency Endotracheal Intubation.

Video laryngoscopy (VL) is still a relatively novel advancement in airway management that offers many potential benefits over direct laryngoscopy. These advantages include decreased time to intubation in difficulty airways, unique opportunities in teaching as the video screen allows for real time teaching points, increased first pass success, particularly with novice operators, and decreased ce...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • British journal of anaesthesia

دوره 102 3  شماره 

صفحات  -

تاریخ انتشار 2009