BJA Advance Access published online on July 25, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen207
Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study
1 Department of Anesthesiology, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1241, Japan
2 Department of Anesthesiology, Iida Municipal Hospital, 438 Yawata, Iida, Nagano 395-8502, Japan
3 Department of Radiology, Aizawa Hospital, 2-5-1 Honjyo, Matsumoto, Nagano 390-8510, Japan
* Corresponding author. E-mail: kmaruyam{at}saitama-med.ac.jp
Background: The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C-spine movement during tracheal intubation with the AWS and or the Macintosh laryngoscope with in-line stabilization (ILS).
Methods: Thirteen patients with a normal C-spine and scheduled for elective surgery agreed to simulation of an unstable C-spine and ILS. Two attempts at laryngoscopy were allowed. Laryngoscopy was performed with the Macintosh laryngoscope, then with the AWS, or vice versa. The movement of the upper C-spine during intubation was examined by measuring the angles formed by adjacent vertebrae from the occiput to C4. Time to achievement of intubation was also recorded.
Results: The AWS significantly decreased median movement of the C-spine at the occiput/C1, C1/C2, and C3/C4 concentrations (P=0.041, 0.0079, and 0.0050, respectively), resulting in a significant decrease in cumulative upper C-spine movement (13.5° with the AWS compared with 30.5° with the Macintosh laryngoscope, P<0.01). Intubation time did not differ [23.8 (SD 16.7) s with the AWS; 17.9 (6.4) s with the Macintosh].
Conclusions: In comparison with the use of the Macintosh laryngoscope, the AWS decreased median upper C-spine movement during intubation under ILS in patients with normal C-spine.
Keywords: airway; anaesthetic techniques, laryngoscopy; anatomy, cervical vertebra; complications, neurological; equipment, laryngoscopes
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
|
|
F. Martin and D. J. Buggy New airway equipment: opportunities for enhanced safety Br. J. Anaesth., June 1, 2009; 102(6): 734 - 738. [Full Text] [PDF]
|
|
|
|
|
|
K. Maruyama, T. Yamada, K. Hara, H. Nakagawa, and A. Kitamura Tracheal intubation using an AirWay Scope(R) in a patient with Halo-Vest Fixation for upper cervical spine injury Br. J. Anaesth., April 1, 2009; 102(4): 565 - 566. [Full Text] [PDF]
|
|
E-letters:
Read all E-letters
- Cervical-spine motion with the AirWay Scope or Macintosh laryngoscope
- David Turnbull, et al.
- British Journal of Anaesthesia, 10 Oct 2008 [Full text]