Document Detail


Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope.
MedLine Citation:
PMID:  22091734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R A Lee; A A J van Zundert; R L J G Maassen; P A Wieringa
Related Documents :
17585254 - Mechanical behavior of the lamb growth plate in response to asymmetrical loading: a mod...
7855674 - Ratings of perceived thigh and back exertion in forest workers during repetitive liftin...
14656664 - Distribution of in situ forces in the anterior cruciate ligament in response to rotator...
9808304 - Damping of the wrist joint during voluntary movement.
18850934 - Coriolis effects on fingering patterns under rotation.
12879184 - Elbow impedance during goal-directed movements.
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-10-14
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  56     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-12     Completed Date:  2012-05-01     Revised Date:  2012-05-16    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.
Affiliation:
Department of Biomechanical Engineering, Delft University of Technology, The Netherlands.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
Acta Anaesthesiol Scand. 2012 May;56(5):663-4; author reply 664-5   [PMID:  22313543 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Exposure to acute stress is associated with attenuated sweet taste.
Next Document:  Interaction Terms in Nonlinear Models.