Upper cervical spine movement during intubation: fluoroscopic comparison of the AirWay Scope, McCoy laryngoscope, and Macintosh laryngoscope
1 Department of Anesthesiology
2 Department of Radiology
3 Department of Oral and Maxillofacial Surgery, Iida Municipal Hospital, 438 Yawata, Iida, Nagano 395-8502, Japan
* Corresponding author. E-mail: k-maruyama{at}imh.jp, kmaruyam{at}saitama-med.ac.jp
Background: The AirWay Scope (AWS) is a new fibreoptic intubation device, which allows visualization of the glottic stractures without alignment of the oral, pharyngeal, and tracheal axes, and thus may be useful in patients with limited cervical spine (C-spine) movement. We fluoroscopically evaluated upper C-spine movement during intubation with the AWS or Macintosh or McCoy laryngoscope.
Methods: Forty-five patients, with normal C-spine, scheduled for elective surgery were randomly assigned to one of the three intubation devices. Movement of the upper C-spine was examined by measuring angles formed by adjacent vertebrae during intubation. Time to intubation was also recorded.
Results: Median cumulative upper C-spine movement was 22.3°, 32.3°, and 36.5° with the AWS, Macintosh laryngoscope, and McCoy laryngoscope, respectively (P<0.001, AWS vs, Macintosh and McCoy). The AWS reduced maximum movement of the C-spine at C1/C2 in comparison with the Macintosh or McCoy laryngoscope (P=0.012), and at C3/C4 in comparison with the McCoy laryngoscope (P=0.019). Intubation time was significantly longer in the AWS group than in the Macintosh group (P=0.03).
Conclusions: Compared with the Macintosh or McCoy laryngoscope, the AWS produced less movement of upper C-spine for intubation in patients with a normal C-spine.
Keywords: airway, patency; anaesthetic techniques, laryngoscopy; complications, spinal injury; equipment, airway; equipment, laryngoscope
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. A. Malik, R. Subramaniam, C. H. Maharaj, B. H. Harte, and J. G. Laffey Randomized controlled trial of the Pentax AWS(R), Glidescope(R), and Macintosh laryngoscopes in predicted difficult intubation Br. J. Anaesth., November 1, 2009; 103(5): 761 - 768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. H. C. Liu, R. W. L. Goy, B. H. Tan, and T. Asai Tracheal intubation with videolaryngoscopes in patients with cervical spine immobilization: a randomized trial of the Airway Scope(R) and the GlideScope(R) Br. J. Anaesth., September 1, 2009; 103(3): 446 - 451. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Malik, R. Subramaniam, S. Churasia, C. H. Maharaj, B. H. Harte, and J. G. Laffey Tracheal intubation in patients with cervical spine immobilization: a comparison of the Airwayscope(R), LMA CTrach(R), and the Macintosh laryngoscopes Br. J. Anaesth., May 1, 2009; 102(5): 654 - 661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Malik, C. O'Donoghue, J. Carney, C. H. Maharaj, B. H. Harte, and J. G. Laffey Comparison of the Glidescope(R), the Pentax AWS(R), and the Truview EVO2(R) with the Macintosh laryngoscope in experienced anaesthetists: a manikin study Br. J. Anaesth., January 1, 2009; 102(1): 128 - 134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Malik, C. H. Maharaj, B. H. Harte, and J. G. Laffey Comparison of Macintosh, Truview EVO2(R), Glidescope(R), and Airwayscope(R) laryngoscope use in patients with cervical spine immobilization Br. J. Anaesth., November 1, 2008; 101(5): 723 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Maruyama, T. Yamada, R. Kawakami, and K. Hara Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study Br. J. Anaesth., October 1, 2008; 101(4): 563 - 567. [Abstract] [Full Text] [PDF]
|
|