| Sniffing position improves pharyngeal airway patency in anesthetized patients with obstructive sleep apnea. | |
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MedLine Citation:
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PMID: 16129972 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Appropriate bag-and-mask ventilation with patent airway is mandatory during induction of general anesthesia. Although the sniffing neck position is a traditionally recommended head and neck position during this critical period, knowledge of the influences of this position on the pharyngeal airway patency is still inadequate. METHODS: Total muscle paralysis was induced with general anesthesia in 12 patients with obstructive sleep apnea, eliminating neuromuscular factors contributing to pharyngeal patency. The cross-sectional area of the pharynx was measured endoscopically at different static airway pressures. Comparison of static pressure-area plot between the neutral and sniffing neck positions allowed assessment of the influence of the neck position change on the mechanical properties of the pharynx. RESULTS: The static pressure-area curves of the sniffing position were above those of neutral neck position, with increasing maximum cross-sectional area and decreasing the closing pressure at both retropalatal and retroglossal airways. The beneficial effects of the sniffing position were greater in obstructive sleep apnea patients with higher closing pressure and smaller body mass index. CONCLUSIONS: Sniffing position structurally improves maintenance of the passive pharyngeal airway in patients with obstructive sleep apnea and may be beneficial for both mask ventilation and tracheal intubation during anesthesia induction. |
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Authors:
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Shiroh Isono; Atsuko Tanaka; Teruhiko Ishikawa; Yugo Tagaito; Takashi Nishino |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 103 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-08-30 Completed Date: 2005-10-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 489-94 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Graduate School of Medicine, Chiba University, Chiba, Japan. isonos-chiba@umin.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anesthesia* Humans Intubation, Intratracheal Middle Aged Neck Pharynx / physiology* Posture* Respiratory Mechanics Sleep Apnea, Obstructive / physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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