Cervical spine movement during intubation using the Airtraq® and direct laryngoscopy

Erden, İsmail; Pamuk, Almıla Gülsün; Uzun, Şennur; Geyik, Serdar; Çekirge, Saruhan; Aypar, Ülkü

doi:10.3906/sag-0901-14

Cited by 3 publications

(8 citation statements)

References 18 publications

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“…One four-arm crossover trial involved a comparison between Bullard and MAC with and without manual in-line stabilisation (MILS),7 and three trials involved a comparison of three devices 20–22. Data were presented for laryngoscopy only in 8 trials,7 8 10 13–16 18 laryngoscopy and ETI in 1011 12 17 20 21 23–27 and ETI only in 3 9 19 22. Regarding immobilisation techniques, MILS was used in two trials,7 14 medical tapes and/or Velcro in two,12 26 cervical collar in two8 19 and not reported in one 27.…”

Section: Resultsmentioning

confidence: 99%

“…This segment was studied in 15 trials (figure 3 and online supplemental appendix F). 7 8 10 12–18 20 23–25 27 ‘Alternative devices’ caused less cervical movement than MAC (MD of −3.19 (95% CI −4.04 to –2.35), I 2 =36%).…”

Section: Resultsmentioning

confidence: 99%

“…ILMA was studied in three trials,20 23 27 and Airtraq in four trials 13 14 17 24. Both devices caused less movement than MAC (MD of −6.48 (95% CI −8.60 to –4.35), I 2 =0%, and −1.63 (95% CI −3.09 to –0.17), I 2 =0%, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…ILMA was studied in three trials20 23 27 and caused less movement than MAC (MD of −4.48 (95% CI −6.37 to –2.58), I 2 =0%); Airtraq was studied in three trials,13 17 24 revealing no statistically significant differences relative to MAC (MD of −1.22 (95% CI −2.53 to 0.08), I 2 =0%).…”

Section: Resultsmentioning

confidence: 99%

“…This segment was studied in 11 trials9 11 12 17 20 22–27 (figure 4 and online supplemental appendix K); less cervical movement was observed with ‘alternative devices’ compared with MAC (MD of −1.20 (95% CI −2.09 to –0.31), I 2 =0%).…”

Section: Resultsmentioning

confidence: 99%

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Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis

Correa

Felice²,

Sbruzzi³

et al. 2022

Emerg Med J

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BackgroundAirway management is challenging in trauma patients because of the fear of worsening cervical spinal cord damage. Video-integrated and optic-integrated devices and intubation laryngeal mask airways have been proposed as alternatives to direct laryngoscopy with the Macintosh laryngoscope (MAC). We performed a meta-analysis to clarify which devices cause less cervical movement during airway management.MethodsWe searched MEDLINE, Cochrane Central, Embase and LILACS from inception to January 2022. We selected randomised controlled trials comparing alternative devices with the MAC for cervical movement from C0 to C5 in adult patients, evaluated by radiological examination. Additionally, cervical spine immobilisation (CSI) techniques were evaluated. We used the Cochrane Risk of Bias Tool to evaluate the risk of bias, and the principles of the Grading of Recommendations, Assessment, Development, and Evaluations system to assess the quality of the body of evidence.ResultsTwenty-one studies (530 patients) were included. Alternative devices caused statistically significantly less cervical movement than MAC during laryngoscopy with mean differences of −3.43 (95% CI −4.93 to –1.92) at C0–C1, −3.19 (–4.04 to –2.35) at C1–C2, −1.35 (−2.19 to −0.51) at C2–C3, and −2.61 (–3.62 to –1.60) at C3–C4; and during intubation: −3.60 (–5.08 to –2.12) at C0–C1, −2.38 (−3.17 to −1.58) at C1–C2, −1.20 (–2.09 to –0.31) at C2–C3. The Airtraq and the Intubation Laryngeal Mask Airway caused statistically significant less movement than MAC restricted to some cervical segments, as well as CSI. Heterogeneity was low to moderate in most results. The quality of the body of evidence was ‘low’ and ‘very low’.ConclusionsCompared with the MAC, alternative devices caused less movement during laryngoscopy (C0–C4) and intubation (C0–C3). Due to the high risk of bias and the very low grade of evidence of the studies, further research is necessary to clarify the benefit of each device and to determine the efficacy of cervical immobilisation during airway management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis

Correa

Felice²,

Sbruzzi³

et al. 2022

Emerg Med J

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The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

Aydın

Çakmakçı

2014

Turk J Med Sci

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The utilisation of whey is very important for preventing the waste of a protein-and lactose-rich dairy by product and protecting the environment. Therefore, the objective of this study was to investigate the effect of whey use in tel (wire) kadayıf (a Turkish dessert raw material) production on microbiological and technological properties and sensory characteristics of tel kadayıf. For this purpose, 3 experimental tel kadayıf samples were produced using different amounts (0%, 25%, and 50%) of fresh whey instead of water in the production of raw tel kadayıf. The samples were placed in plastic bags and vacuum packaging and stored in a refrigerator (4 °C). Storage period (1, 3, 5, and 7 days) analysis was performed. The results of the research showed that nutritional value and sweetness increased, while the baking time decreased with respect to increases in the amount of whey used in tel kadayıf. As a result of a collective evaluation of the study findings, it was concluded that a 25% whey addition and vacuum packaging would provide the most positive quality characteristics in tel kadayıf desserts.

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A comparative study to evaluate the cervical spine movements during laryngoscopy using Macintosh and Airtraq laryngoscopes

Kaur,

Raja,

Kumar

et al. 2023

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aim: Intubation with Macintosh requires flexing the lower cervical spine and extending the atlanto-occipital joint to create a “line of sight.” Primary aim of study was to compare the extent of cervical spine movement during laryngoscopy using conventional Macintosh laryngoscope and Airtraq. Material and Methods: A total of 25 patients of either sex between the age group of 18 and 60 years, having American Society of Anesthesiologists (ASA) physical status of Grade-I and Grade-II, scheduled for elective surgery under image control requiring general anesthesia and intubation were enrolled. A baseline image of the lateral cervical spine including the first four cervical vertebrae was taken by an image intensifier. After administration of general anesthesia, laryngoscopy was first performed using a Macintosh laryngoscope and a second X-ray image of the lateral cervical spine was taken. The second laryngoscopy using a Airtraq laryngoscope was done and the third image of the lateral cervical spine was taken. Angles between occiput and C1; C1 and C2; C2 and C3; C3 and C4; and occiput and C4 were calculated. Atlanto-occipital distance (AOD) was calculated as the distance between occiput and C1. Results: Macintosh showed greater cervical movement as compared with Airtraq but a significant difference in the movement was observed at C2–C3 and C0–C4. Baseline mean AOD was 2.21 ± 1.25 mm, after Macintosh and Airtraq laryngoscopy was found to be 1.13 ± 0.60 and 1.6 ± 0.78 mm, respectively, and was found to be significant (P < 0.05). Conclusion: We conclude that Airtraq allows intubation with less movement of the upper cervical spine makes Airtraq preferred equipment for intubation in patients with a potential cervical spine injury.

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Cervical spine movement during intubation using the Airtraq® and direct laryngoscopy

Cited by 3 publications

References 18 publications

Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis

Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis

The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

A comparative study to evaluate the cervical spine movements during laryngoscopy using Macintosh and Airtraq laryngoscopes

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