Cricoid pressure impedes tracheal intubation with the Pentax-AWS Airwayscope®: a prospective randomized trial

Abstract

UMIN000018209.

Effect of cricoid pressure on the glottic view and intubation with king vision® video laryngoscope

“…This was similar to study conducted by Komasawa et al on Penatax-AWS airway scope which did not show any difference in CL grading ( P = 0.49) and POGO ( P = 0.60) with and without CP. [16] Kleine-Brueggeney et al showed the median percentile of POGO was 100 in GlideScope ® ; 90 in C MAC-D blade, Mc Grath, Airtraq, and Kingvision; 60 in A.P. Advance.…”

“…[30] The increase in angle as the trachea is pushed downward during CP may exacerbate this potential problem of tube placement through glottis. [16] “Neck antiflexion” (head elevation) after laryngoscopy has been proposed to alleviate this deviation and facilitate the smooth passage of the tube. [31] At the same time, Mendonca et al did not find any significant difference in laryngoscopy time ( P = 0.020), intubation time ( P = 0.272), and success rate ( P = 0.968) with use of KVL or C MAC with the patients in neutral and sniffing position.…”

“…[32] Komasawa et al found 96% success with the first attempt of insertion of airway scope and 80% first attempt for passage of tube and a median intubation time of 32 s (IQR-28–45). [16] The above studies indicate that different designs of the blade in VLS (shape, curvature, and position of the video camera) influence the performance of the device.…”

“…Komasawa et al found a prolonged intubation time with Pentax AWS and CP (median [IQR]) (45 [40–59]) compared to control (32 [28–45]) with 95% confidence interval for the median difference of 5–24 s ( P = 0.003). [16] The number of attempts for insertion of device ( P = 0.08) was insignificant, but had a significant difference in number of attempts for ETT insertion ( P = 0.002). Arslan and Solak found median (25–75 percentile) insertion time of 12 s (9–15.8) in Macintosh and 13 s (11–17) in Mc Grath, but significantly prolonged ( P < 0.001) in GlideScope 18 s (14–22) in all patients with CP.…”

The Clarus Video System (Trachway) and direct laryngoscope for endotracheal intubation with cricoid pressure in simulated rapid sequence induction intubation: a prospective randomized controlled trial

“…When properly applied, CP may not affect glottic view during endotracheal intubation with either a direct laryngoscope (DL) or a video laryngoscope [4–6]. However, the application of CP is likely to prolong the intubation time [5, 6]. Limited mouth opening or vulnerable teeth, which often accompany the patients requiring emergency intubation, are the two common factors to deter the intubators from using a laryngoscopic device.…”