Cervical spine movement during orotracheal intubation: comparison of the Belscope and Macintosh blades

Background In the emergency trauma situation, in-line stabilization (ILS) of the cervical spine is used to reduce head and neck extension during laryngoscopy. The Bullard laryngoscope may result in less cervical spine movement than the Macintosh laryngoscope. The aim of this study was to compare cervical spine extension (measured radiographically) and time to intubation with the Bullard and Macintosh laryngoscopes during a simulated emergency with cervical spine precautions taken. Methods Twenty-nine patients requiring general anesthesia and endotracheal intubation were studied. Patients were placed on a rigid board and anesthesia was induced. Laryngoscopy was performed on four occasions: with the Bullard and Macintosh laryngoscopes both with and without manual ILS. Cricoid pressure was applied with ILS. To determine cervical spine extension, radiographs were exposed before and during laryngoscopy. Times to intubation and grade view of the larynx were also compared. Results Cervical spine extension (occiput-C5) was greatest with the Macintosh laryngoscope (25.9 degrees +/- 2.8 degrees). Extension was reduced when using the Macintosh laryngoscope with ILS (12.9 +/- 2.1 degrees) and the Bullard laryngoscope without stabilization (12.6 +/- 1.8 degrees; P < 0.05). Times to intubation were similar for the Macintosh laryngoscope with ILS (20.3 +/- 12.8 s) and for the Bullard without ILS (25.6 +/- 10.4 s). Manual ILS with the Bullard laryngoscope results in further reduction in cervical spine extension (5.6 +/- 1.5 degrees) but prolongs time to intubation (40.3 +/- 19.5 s; P < 0.05). Conclusions Cervical spine extension and time to intubation are similar for the Macintosh laryngoscope with ILS and the Bullard laryngoscope without ILS. However, time to intubation is significantly prolonged when the Bullard laryngoscope is used in a simulated emergency with cervical spine precautions taken. This suggests that the Bullard laryngoscope may be a useful adjunct to intubation of patients with potential cervical spine injury when time to intubation is not critical.

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Cervical spine movement using the Airway Scope

Anaesthesia ◽

10.1111/j.1365-2044.2007.05420_1.x ◽

2008 ◽

Vol 63 (2) ◽

pp. 207-208 ◽

Cited By ~ 2

Author(s):

S. H. McClelland ◽

R. A. McCahon ◽

A. M. Norris

Keyword(s):

Cervical Spine ◽

Airway Scope ◽

Spine Movement

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Segmental Cervical Spine Movement with the Intubating Laryngeal Mask During Manual In-Line Stabilization in Patients with Cervical Pathology Undergoing Cervical Spine Surgery

Anesthesia & Analgesia ◽

10.1097/00000539-200007000-00037 ◽

2000 ◽

Vol 91 (1) ◽

pp. 195-200 ◽

Cited By ~ 6

Author(s):

S. Kihara ◽

S. Watanabe ◽

J. Brimacombe ◽

N. Taguchi ◽

Y. Yaguchi ◽

...

Keyword(s):

Cervical Spine ◽

Spine Surgery ◽

Laryngeal Mask ◽

Cervical Spine Surgery ◽

Spine Movement

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Cervical Spine Movement During Laryngoscopy with the Bullard, MacIntosh, and Miller Laryngoscopes

Survey of Anesthesiology ◽

10.1097/00132586-199608000-00058 ◽

1996 ◽

Vol 40 (4) ◽

pp. 251 ◽

Cited By ~ 1

Author(s):

RANDOLPH H. HASTINGS ◽

A. CHRISTOPHER VIGIL ◽

RICHARD HANNA ◽

BOR-YAU YANG ◽

DAVID J. SARTORIS

Keyword(s):

Cervical Spine ◽

Spine Movement

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Observation of a Cervical Spine Movement Therapy: A Case of College Students

Proceedings of the 2015 International Conference on Social Science, Education Management and Sports Education ◽

10.2991/ssemse-15.2015.105 ◽

2015 ◽

Author(s):

Xiao Yan ◽

Yanqun Wang ◽

Kai Li

Keyword(s):

College Students ◽

Cervical Spine ◽

Movement Therapy ◽

Spine Movement

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TRACHEAL INTUBATION DURING MANUAL INLINE STABILISATION: COMPARISON OF INTUBATING LARYNGEAL MASK AIRWAY™ VERSUS TRACHLIGHT®

10.36106/ijar/4308961 ◽

2021 ◽

pp. 60-62

Author(s):

Manjunath Prabhu ◽

Shwethapriya Rao ◽

Arushi Gupta

Keyword(s):

Cervical Spine ◽

Laryngeal Mask Airway ◽

Tracheal Intubation ◽

Laryngeal Mask ◽

P Value ◽

Stabilization Method ◽

Intubating Laryngeal Mask Airway ◽

Effective Ventilation ◽

Unstable Cervical Spine ◽

Spine Movement

Introduction: Airway management with unstable cervical spine is a major challenge to anesthetist. Conventional direct laryngoscopy causes substantial movement of cervical spine and can cause neurological decit. Newer devices like Intubating Laryngeal Mask Airway(ILMA) and Trachlight avoid cervical spine movement. To compare rate of successful tracheal Aim: intubation with Intubating Laryngeal Mask Airway™ with Trachlight® in anaesthetised and paralysed adults with manual in line stabilization Method and Materials: 50 patients were included in the study and allocated in two groups. In the ILMA group ,patients were ventilated and then intubated through the ILma. IN the Trachlight group, patients were intubated using trachlight. Success rate , time taken for intubation and post operative sore throat and hoarseness of voice were compared between the two groups. Results: In the ILMA group,21 patients could be adequately ventilated in the rst attempt and 4 in second attempt. 12 patients could be successfully intubated. 9 patients could be intubated in the rst attempt and 3 patients in second attempt. In the Trachlight , 24 patients could be intubated in the rst attempt and one patient in second attempt. Intubation time was 14.08 ± 2.23 seconds in the ILMA group whereas in Trachlight group it was 26.48 ± 9.13 seconds(p value of <0.0001) In healthy anaesthetized,paralysed adults with manual in line stabiliz Conclusion: ation Trachlight assistance at tracheal intubation provides high rst attempt success.ILMA is an effective ventilation device, but an unacceptably high failure rate at blind tracheal intubation.

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