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BJA Advance Access originally published online on July 4, 2007
British Journal of Anaesthesia 2007 99(4):581-586; doi:10.1093/bja/aem095
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Laryngeal exposure during laryngoscopy is better in the 25° back-up position than in the supine position

B. J. Lee, J. M. Kang* and D. O. Kim

Department of Anaesthesiology, Kyung Hee University, East–West Neo Medical Center, 149 Sangil-dong Gangdong-Gu, Seoul 134-090, Korea

* Corresponding author. E-mail: kjm{at}khnmc.or.kr

Background: Good visualization of the glottis is important for tracheal intubation. This study evaluated whether the 25° back-up position improves the quality of the laryngeal view during laryngoscopy.

Methods: Laryngoscopy with a curved blade was performed on 40 anaesthetized patients. The patients were randomly assigned to two groups. Laryngeal views were captured with a rigid 0° endoscope. Views were recorded for each patient in Group A (n = 20) during laryngoscopies performed with the patient lying first in the supine position and then in the 25° back-up position. Laryngeal views for patients in Group B (n = 20) were first captured while the patient was in the 25° back-up position and then while the patient was in the flat supine position. An anaesthetist blinded to the position graded the quality of the images using the percentage of glottic opening (POGO) score.

Results: Comparing the two positions, mean (SD) POGO scores increased significantly from 42.2 (27.4)% in supine position to 66.8 (27.6)% in 25° back-up position (P < 0.0001).

Conclusions: During laryngoscopy, the laryngeal view, as assessed by POGO scores, improves significantly in the 25° back-up position when compared with the flat supine position.

Keywords: anaesthetic techniques; laryngoscopy; measurement techniques; endoscopy; position; intubation


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[Abstract] [Full Text] [PDF]

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Effect of 25˚ back-up position on laryngeal view at laryngoscopy
Gavin Drummond, et al.
British Journal of Anaesthesia, 20 Nov 2007 [Full text]
Re: Effect of 25˚ back-up position on laryngeal view at laryngoscopy
Jong-Man Kang
British Journal of Anaesthesia, 29 Jun 2008 [Full text]

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