Assessment of cervical spine movement during laryngoscopy with Macintosh and Truview laryngoscopes

Bhardwaj, Neerja; Jain, Kajal; Rao, Madhusudan; Mandal, Arup Kumar

doi:10.4103/0970-9185.117053

Cited by 18 publications

(17 citation statements)

References 21 publications

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“…There was a significant difference between the two groups in the mean heart rate at minute 3 (p-value=0.03), the mean systolic/diastolic pressure at all minutes, and the mean SaO2 at minute 4 (p-value=0.003). In a study by Bhardwaj conducted in 2013 to evaluate cervical spine motion with a Macintosh laryngoscope and a Trueview laryngoscope, the authors found that the latter offered a better laryngoscopic view of the glottis and less cervical spine motion [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Laryngoscopic View using Macintosh and Miller Blades in Children Less than Four Years Old

et al. 2020

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This study aimed to compare Miller and Macintosh laryngoscopes in zero to 4-year-old children. A total of 72 children with a score of I and II, according to the American Society of Anesthesiologists (ASA) physical status classification, who were candidates for elective surgery with general anesthesia and tracheal intubation were enrolled in the study. The children were divided into two equal groups (36 persons) according to used laryngoscope: Miller laryngoscope (group 1) and Macintosh laryngoscope (group 2). Observations and all laryngoscopies were performed by a single experienced anesthesiologist. Heart rate, systolic blood pressure, non-invasive arterial blood pressure, and hemoglobin saturation were measured and recorded. The number of endotracheal intubation attempts and complications were also recorded for both groups. In terms of gender, the first group consisted of 88.9% boys and 11.1% girls, and the second group consisted of 66.6% boys and 33.3% girls (p-value=0.05). The mean age was 16.7 months in the first group and 17.7 months in the second group (p-value=0.5). The mean weight of the children was 16988.5 g and 16300 g in the Miller and Macintosh groups, respectively (p-value=0.9). Regarding the Cormack-Lehane classification system, 5 patients were classified as grade 1 (13.9%), 14 patients as grade 2 (38.9%), 15 patients as grade 3 (41.7%), and 2 patients as grade 4 (5.6%) in the Macintosh group. In contrast, in the Miller group, 5 patients were classified as grade 1 (13.9%), 27 patients as grade 2 (75%), and 4 patients as grade 3 (11.1%) (p-value=0.004). These results can provide more data about the tracheal intubation method with the Macintosh and Miller laryngoscopes, the ease of intubation, and the best laryngoscopic view with each blade.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Laryngoscopic View using Macintosh and Miller Blades in Children Less than Four Years Old

et al. 2020

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“…Cervical spine movement during intubation is prevented by manual inline stabilization by an assistant throughout the procedure [44] . Use of McCoy laryngoscope, bougies and videolaryngoscope have been studied and found to have less cervical movement during intubation and should be preferred [30,[47][48][49] .…”

Section: Cervical Spine Injurymentioning

confidence: 99%

Anesthetic Challenges and Management of Maxillofacial Trauma

Gupta¹,

Singh²,

Kumar³

et al. 2017

JAS

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Management of Maxillofacial trauma is a challenging task for an anaesthesiologist. It requires a prompt and skillful response from the anaesthesia team. Bilateral parasymphsial fracture, condylar fracture, fracture of zygoma, flattening of face, moderate bleeding and derranged occlusion are the main cautionary pointers of difficult airway. Emergency airway management should be done by a team led by an anaesthesiologist. A difficult airway cart along with resuscitation trolley should be ready. Plan A should be direct laryngoscopy and manual in line stabilization. Video laryngoscope if available should be preferred. Plan B must include fiberoptic, optical and lighted stylets and airway rescue supraglottic devices. Surgical access should be used as backup plan C. Elective management for definitive surgery should be based on specific maxillofacial trauma, surgical approach, associated inflammation and need of prolonged mechanical ventilation in postoperative period.

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“…In addition, “in-line stabilization” worsens the laryngoscopic view which may, in turn, worsen the outcome in traumatic brain injury by delaying endotracheal intubation and causing hypoxia [ 15 , 16 ]. Using a video laryngoscope, instead of a conventional laryngoscope with a Macintosh blade, may be beneficial for intubating patients whose neck position needs to be in a neutral position and their cervical spine requires immobilization [ 17 – 19 ]. Neck movements during laryngoscopy using a conventional Macintosh laryngoscope has been compared to that using the GlideScope video laryngoscope [ 18 ] and the Truview PCD laryngoscope [ 19 ].…”

Section: Early Airway Maintenancementioning

confidence: 99%

“…Using a video laryngoscope, instead of a conventional laryngoscope with a Macintosh blade, may be beneficial for intubating patients whose neck position needs to be in a neutral position and their cervical spine requires immobilization [ 17 – 19 ]. Neck movements during laryngoscopy using a conventional Macintosh laryngoscope has been compared to that using the GlideScope video laryngoscope [ 18 ] and the Truview PCD laryngoscope [ 19 ]. The results of the two studies found that the number of neck movements is reduced when using the video laryngoscopes for endotracheal intubation.…”

Section: Early Airway Maintenancementioning

confidence: 99%

Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach

Barák

Bahouth

Leiser

et al. 2015

BioMed Research International

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According to the Advanced Trauma Life Support recommendations for managing patients with life-threatening injuries, securing the airway is the first task of a primary caregiver. Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient's survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient's airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Additionally, some of these patients may not yet have been cleared of a cervical spine injury, and all are regarded as having a full stomach and having an increased risk of regurgitation and pulmonary aspiration. The requirements of the intended maxillofacial operation may often preclude the use of an oral intubation tube, and alternative methods for securing the airway should be considered before the start of the surgery. In order to improve the clinical outcome of patients with maxillofacial trauma, cooperation between maxillofacial surgeons, anesthesiologists, and trauma specialists is needed. In this review, we discuss the complexity and difficulties of securing the airway of patients with maxillofacial trauma and present our approach for airway management of such patients.

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Assessment of cervical spine movement during laryngoscopy with Macintosh and Truview laryngoscopes

Cited by 18 publications

References 21 publications

Comparison of the Laryngoscopic View using Macintosh and Miller Blades in Children Less than Four Years Old

Comparison of the Laryngoscopic View using Macintosh and Miller Blades in Children Less than Four Years Old

Anesthetic Challenges and Management of Maxillofacial Trauma

Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach

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