| Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope. | |
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MedLine Citation:
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PMID: 22091734 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade. METHODS: Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope(®) (Verathon Inc., Bothell, WA, USA), V-Mac™ Storz(®) (Karl Storz, Tuttlingen, Germany), and McGrath™ (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz(®) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior to the vocal cords, with actual intubation carried out only with the second of the laryngoscopes. Sensors measured the forces directly applied to the patient's maxillary incisors while inserting the ETT. Other common metrics of intubation difficulty (e.g. Mallampati grade, Cormack-Lehane grade, and time) were also recorded. RESULTS: Only one patient was not intubated within the standard study parameters and was converted to the hospital protocols for difficult intubations. The forces applied to the maxillary incisors were significantly greater with the Macintosh blade compared with all VLSs. There were no differences between the VLSs with regard to the forces. Patient characteristics, including Mallampati grade, were not predictive of the forces applied. CONCLUSIONS: All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy. |
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Authors:
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R A Lee; A A J van Zundert; R L J G Maassen; P A Wieringa |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2011-10-14 |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 56 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-12 Completed Date: 2012-05-01 Revised Date: 2012-05-16 |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 224-9 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation. |
Affiliation:
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Department of Biomechanical Engineering, Delft University of Technology, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Equipment Design Female Humans Incisor / physiology* Intubation, Intratracheal Laryngoscopes / adverse effects* Male Maxilla / physiology* Middle Aged Monitoring, Intraoperative Pressure Risk |
| Comments/Corrections | |
Comment In:
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Acta Anaesthesiol Scand. 2012 May;56(5):663-4; author reply 664-5
[PMID:
22313543
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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