Cervical Spine Movement During Awake Orotracheal Intubation With Fiberoptic Scope and McGrath Videolaryngoscope in Patients Undergoing Surgery for Cervical Spine Instability: A Randomized Control Trial

Background: Cervical spondylosis is defined as degenerative changes occurring in the discs and cervical spine. Stating these changes is to be almost universal in the elderly. Cervical Spondylosis correlated with Manyagraha in Ayurvedic perspective. Aim: Aim of the study was to evaluate the effect of Erandamula Ghanavati and Anu Taila Nasya in Manyagraha. Methods: The Group in which Erandamula Ghanavati and Anutaila Nasya were given to patients was termed as Trial Group. The Group in which Panchatikta Ghrita Guggulu and Anutaila Nasya were given to patients was termed as Control Group. During this study 104 patients out of 150 were equally divided into Trial and Control Group by lottery method and comparative study was done. Statistical analysis was done using appropriate tests. Results: Erandamula Ghanavati along with Anu Taila Nasya has reduces symptoms of Manyagraha. Total effect of therapy is more in Trial group as compared to the Control Group. Discussion: As stated by Charak Erandamula is best Vatahara drug. Its Rasa, Virya and Vipak are helpful to alleviate Vata. Erandamula having Snigdha, Madhuraproperties is going to be beneficial in Dhatukshayajanya Vatavyadhi. Conclusion: Erandamula Ghanavati along with Anu Taila Nasya has beneficial for patients of Manyagraha.

Download Full-text

Comparison of Cervical Spine Movement by Airway Equipment during Orotracheal Intubation: A Manikin Pilot Study

The Korean Journal of Critical Care Medicine ◽

10.4266/kjccm.2010.25.4.230 ◽

2010 ◽

Vol 25 (4) ◽

pp. 230

Author(s):

Sang Hyun Lee ◽

Hyuk Choong Choi ◽

Hyung Goo Kang ◽

Bo Seung Kang ◽

Tai Ho Lim

Keyword(s):

Cervical Spine ◽

Pilot Study ◽

Orotracheal Intubation ◽

Airway Equipment ◽

Spine Movement

Download Full-text

Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0021 ◽

2019 ◽

Vol 28 (7) ◽

pp. 764-768 ◽

Cited By ~ 1

Author(s):

Steven Nagib ◽

Shelley W. Linens

Keyword(s):

Cervical Spine ◽

Exploratory Study ◽

Randomized Control Trial ◽

Chart Review ◽

Vestibular Rehabilitation ◽

Postconcussion Syndrome ◽

Bottom Line ◽

Rehabilitation Therapy ◽

Perceived Disability ◽

Randomized Control

Clinical Scenario:Every year, millions of people suffer a concussion. A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. Clinicians are beginning to incorporate vestibular rehabilitation therapy (VRT) in their postconcussion treatment plan, in order to address the dysfunctional inner ear structures that could be causing this dizziness.Focused Clinical Question:Can VRT help postconcussion syndrome patients experiencing prolonged dizziness by improving their perceived disability?Summary of Key Findings:Three studies were included: 1 randomized control trial, 1 retrospective chart review, and 1 exploratory study. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores.Clinical Bottom Line:There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. VRT is a relatively safe treatment option, with no adverse reactions or case reports.Strength of Recommendation:There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion.

Download Full-text

Manual In-line Stabilization Increases Pressures Applied by the Laryngoscope Blade during Direct Laryngoscopy and Orotracheal Intubation

Anesthesiology ◽

10.1097/aln.0b013e318190b556 ◽

2009 ◽

Vol 110 (1) ◽

pp. 24-31 ◽

Cited By ~ 71

Author(s):

Brandon G. Santoni ◽

Bradley J. Hindman ◽

Christian M. Puttlitz ◽

Julie B. Weeks ◽

Nathaniel Johnson ◽

...

Keyword(s):

Cervical Spine ◽

Direct Laryngoscopy ◽

Random Order ◽

Orotracheal Intubation ◽

Laryngoscope Blade ◽

Cervical Instability ◽

Cervical Spine Instability ◽

Pressure Application ◽

Glottic View ◽

Cervical Motion

Background Manual in-line stabilization (MILS) is recommended during direct laryngoscopy and intubation in patients with known or suspected cervical spine instability. Because MILS impairs glottic visualization, the authors hypothesized that anesthesiologists would apply greater pressure during intubations with MILS than without. Methods Nine anesthetized and pharmacologically paralyzed patients underwent two sequential laryngoscopies and intubations, one with MILS and one without, in random order. A transducer array along a Macintosh 3 laryngoscope blade continuously measured applied pressures, and glottic view was characterized. Results With MILS, glottic visualization was worse in six patients, and intubation failure occurred in two of these six patients. Maximum laryngoscope pressure at best glottic view was greater with MILS than without (717 +/- 339 mmHg vs. 363 +/- 121 mmHg, respectively; n = 8; P = 0.023). Other measures of pressure application also indicated comparable increases with MILS. Conclusion Pressures applied to airway tissues by the laryngoscope blade are secondarily transmitted to the cervical spine and result in cranio-cervical motion. In the presence of cervical instability, impaired glottic visualization and secondary increases in pressure application with MILS have the potential to increase pathologic cranio-cervical motion.

Download Full-text