Videolaryngoscopy with Glidescope Reduces Cervical Spine Movement in Patients with Unsecured Cervical Spine

Kill, Clemens; Risse, Joachim; Wallot, Pascal; Seidl, Philipp; Steinfeldt, Thorsten; Wulf, Hinnerk

doi:10.1016/j.jemermed.2012.07.080

Cited by 65 publications

(27 citation statements)

References 28 publications

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“…as they did not include patients with apparent airway difficulty in their research . Although cervical spine immobility can make intubation more challenging, it has been shown that videolaryngoscopes are associated with less cervical spine movement . These participants may have had relatively easier airways and this may have accounted for the shorter intubation times found in this study.…”

Section: Discussionmentioning

confidence: 89%

Videolaryngoscopy vs. fibreoptic bronchoscopy for awake tracheal intubation: a systematic review and meta‐analysis

et al. 2018

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SummaryAwake fibreoptic intubation is often considered the technique of choice when a difficult airway is anticipated. However, videolaryngoscopes are being used more commonly. We searched the current literature and performed a meta-analysis to compare the use of videolaryngoscopy and fibreoptic bronchoscopy for awake tracheal intubation. Our primary outcome was the time needed to intubate the patient's trachea. Secondary outcomes included: failed intubation; the rate of successful intubation at the first attempt; patient-reported satisfaction with the technique; and any complications resulting from intubation. Eight studies examining 429 patients were included in this review. The intubation time was shorter when videolaryngoscopy was used instead of fibreoptic bronchoscopy (seven trials, 408 participants, mean difference (95%CI) À45.7 (À66.0 to À25.4) s, p < 0.0001, low-quality evidence). There was no significant difference between the two techniques in the failure rate (six studies, 355 participants, risk ratio (95%CI) 1.01 (0.24-4.35), p = 0.99, low-quality evidence) or the first-attempt success rate (six studies, 391 participants, risk ratio (95%CI) 1.01 (0.95-1.06), p = 0.8, moderate quality evidence). The level of patient satisfaction was similar between both groups. No difference was found in two reported adverse events: hoarseness/sore throat (three studies, 167 participants, risk ratio (95%CI) 1.07 (0.62-1.85), p = 0.81, low-quality evidence), and low oxygen saturation (five studies, 337 participants, risk ratio (95%CI) 0.49 (0.22-1.12), p = 0.09, low-quality evidence). In summary, videolaryngoscopy for awake tracheal intubation is associated with a shorter intubation time. It also seems to have a success rate and safety profile comparable to fibreoptic bronchoscopy.

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Section: Discussionmentioning

confidence: 89%

Videolaryngoscopy vs. fibreoptic bronchoscopy for awake tracheal intubation: a systematic review and meta‐analysis

et al. 2018

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“…However, the degree of C-spine movements with videolaryngoscopes remains controversial. GlideScope (Verathon Medical) videolaryngoscopy resulted in reduced movements of the C-spine in patients with unsecured C-spines compared to conventional Macintosh laryngoscope in a study that used video motion analysis (18). Truview videolaryngoscope (Truphatek International, Netanya, Israel) was associated with an improved laryngeal view and less movement at the C-spine (19).…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopic Comparison of Cervical Spine Motion Using LMA CTrach, C-MAC Videolaryngoscope and Macintosh Laryngoscope

Şahin

Arslan

Akansel

et al. 2018

Turk J Anaesth Reanim

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Objective: Endotracheal intubation should be performed with care when cervical spine (C-spine) injury is suspected. The aim of this study was to evaluate the movement of the C-spine using fluoroscopy during intubation with Laryngeal Mask Airway (LMA) CTrach, C-MAC videolaryngoscope and Macintosh laryngoscope. Methods: This was a single-centre, prospective, observational, controlled trial. In total, 22 surgical patients aged 18-65 years planned to undergo operation under general anaesthesia, were enrolled. X-ray images of the C-spine were obtained using fluoroscopy with the patients' head in a neutral position. All patients underwent laryngoscopy using a Macintosh blade, LMA CTrach and C-MAC videolaryngoscope, and fluoroscopic images of the C-spine were obtained. All the patients were intubated at the last laryngoscopy simulation (using the C-MAC). The atlanto-occipital distance (AOD) and angles between C 0 C 1 , C 0 C 2 , C 0 C 3 , C 0 C 4 , C 1 C 2 and C 2 C 3 lines were measured and compared between each device. Results: The mean AOD was measured as 20.4 mm in a neutral position, which decreased to 13.1, 17.2 and 12.3 mm after the insertion of the Macintosh laryngoscope, LMA CTrach and C-MAC videolaryngoscope, respectively. The differences were significant (p<0.001). Moreover, significant difference was noted in C 0 C 2 , C 0 C 3 and C 1 C 2 angles with the insertion of the three devices (p<0.001). The LMA CTrach resulted in significantly lesser C-spine movements in C 0 C 2 , C 0 C 3 and C 0 C 4 angles compared to the Macintosh laryngoscope and C-MAC videolaryngoscope (p<0.001). Conclusion:The LMA CTrach resulted in lesser C-spine movements compared to Macintosh laryngoscope and C-MAC videolaryngoscope. In case of the C-spine injury, LMA CTrach may be preferred and may cause fewer traumas during endotracheal intubation. Keywords: Cervical spine motion, LMA C Trach, videolaryngoscopy, fluoroscopy Amaç: Servikal omurga hasarından şüphelenildiğinde endotrakeal entübasyon dikkatli yapılmalıdır. Bu çalışmanın amacı LMA (Laryngeal Mask Airway) CTrach, C-MAC Videolaringoskop ve Macintosh Laringoskop ile entübasyon sırasında floroskopi ile servikal omurga hareketini değerlendirmektir. Yöntemler: Bu tek merkezli, prospektif, gözlemsel kontrollü bir çalışmaydı. Çalışmaya 18-65 yaşları arasında genel anestezi altında operasyon uygulanan 22 hasta dahil edildi. Endotrakeal entübas-yondan önce, hastanın başı nötr konumda iken servikal omurga floroskopi görüntüleri elde edildi. Tüm hastalarda standart Macintosh laringoskop, LMA CTrach ve C-MAC Videolaringoskop kullanıldı. Laringoskopi simülasyonları sırasında servikal omurgadaki değişikliklerin floroskopik görüntüleri elde edildi. Tüm hastalar son laringoskopi sırasında C-MAC kullanılarak entübe edildi. Floroskopi görüntüleri üzerinde C 0 C 1 , C 0 C 2 , C 0 C 3 , C 0 C 4 , C 1 C 2 ve C 2 C 3 arasındaki Atlantooksipital mesafeler ve açılar ölçüldü ve aradaki farklar cihazlar arasında karşılaştırıldı. Bulgular: Ortalama Atlantooksipital mesafe, nötral pozisyonda 20,4 mm ölçül...

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“…DL can be complicated by many factors that obstruct direct visualization such as pathology to the oropharynx (e.g. tumor) and limited mobility of the cervical spine [1][2][3][4][5]. Videolaryngoscopes (VL), which provide an indirect view of the glottis and vocal cords, have been in use as an adjunct to DL for over a decade [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Videolaryngoscopes (VL), which provide an indirect view of the glottis and vocal cords, have been in use as an adjunct to DL for over a decade [2,6,7]. Due to its ability to see "around the corner" via indirect visualization of the glottic opening, VL has been recommended for intubation in patients with limited neck mobility, airway anatomy that is difficult to visualize, and for training novice intubators in laryngoscopy [1,2,[4][5][6][8][9][10][11]. The King Vision™ VL is a relatively new, single unit, indirect videolaryngoscope that is lightweight, has a self contained highresolution camera, is battery operated, and has a curved blade with the option of a tube-guiding channel for easier intubation.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Cohort Study Comparing Medical Student Intubation on Cadaveric and Manikin Models Using the King Vision™ Videolaryngoscope and Direct Laryngoscopy

Triplett¹

2016

JAICM

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Objective: Compare intubation by medical students with direct laryngoscopy (DL) versus King Vision™ videolaryngoscope in training and cadaveric models.Methods: 24 medical students with no experience intubating humans were randomized into two groups: DL first or King Vision™ videolaryngoscope first. Following a short training, techniques were practiced ona manikin model. Intubation success, ease of use, and one timed manikin intubation was recorded. Students crossed, repeated training and trial with other technique. Students then intubated 3 cadavers with their initial technique, crossed over to intubate these same cadavers using their second technique. Cormack-Lehane (C-L) view of the glottic opening, time to intubation, intubation success, ease of use, and preferred technique were recorded. Results:In manikin intubation, success rate was not significantly different. Mean time to intubation using DL was 19.67 seconds, 11.03 seconds with King Vision™. The median "ease of use" for DL was 7; King Vision™ was 4 (0 easiest, 10 hardest). In cadaver model, the median C-L view was 2 for DL, 1 for King Vision™. Success rates were 82% for DL and 93% for King Vision™. The median "ease of use" for DL was 5 and King Vision™ was 4. Conclusion:The King Vision™ videolaryngoscope had statistically significant improved visualization of the glottic opening, intubation success rate when compared to DL, and was rated easier to use. Given the portable nature, low cost, ease of use, and easy maintenance; the King Vision™ videolaryngoscope should be considered an excellent device for intubation training orany emergent setting where advanced airway management is required.

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Videolaryngoscopy with Glidescope Reduces Cervical Spine Movement in Patients with Unsecured Cervical Spine

Cited by 65 publications

References 28 publications

Videolaryngoscopy vs. fibreoptic bronchoscopy for awake tracheal intubation: a systematic review and meta‐analysis

Videolaryngoscopy vs. fibreoptic bronchoscopy for awake tracheal intubation: a systematic review and meta‐analysis

Fluoroscopic Comparison of Cervical Spine Motion Using LMA CTrach, C-MAC Videolaryngoscope and Macintosh Laryngoscope

A Prospective Cohort Study Comparing Medical Student Intubation on Cadaveric and Manikin Models Using the King Vision™ Videolaryngoscope and Direct Laryngoscopy

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