Tags

Type your tag names separated by a space and hit enter

Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope.
Acta Anaesthesiol Scand. 2012 Feb; 56(2):224-9.AA

Abstract

BACKGROUND

Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade.

METHODS

Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope(®) (Verathon Inc., Bothell, WA, USA), V-Mac™ Storz(®) (Karl Storz, Tuttlingen, Germany), and McGrath™ (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz(®) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior to the vocal cords, with actual intubation carried out only with the second of the laryngoscopes. Sensors measured the forces directly applied to the patient's maxillary incisors while inserting the ETT. Other common metrics of intubation difficulty (e.g. Mallampati grade, Cormack-Lehane grade, and time) were also recorded.

RESULTS

Only one patient was not intubated within the standard study parameters and was converted to the hospital protocols for difficult intubations. The forces applied to the maxillary incisors were significantly greater with the Macintosh blade compared with all VLSs. There were no differences between the VLSs with regard to the forces. Patient characteristics, including Mallampati grade, were not predictive of the forces applied.

CONCLUSIONS

All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy.

Authors+Show Affiliations

Department of Biomechanical Engineering, Delft University of Technology, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22091734

Citation

Lee, R A., et al. "Forces Applied to the Maxillary Incisors By Video Laryngoscopes and the Macintosh Laryngoscope." Acta Anaesthesiologica Scandinavica, vol. 56, no. 2, 2012, pp. 224-9.
Lee RA, van Zundert AA, Maassen RL, et al. Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope. Acta Anaesthesiol Scand. 2012;56(2):224-9.
Lee, R. A., van Zundert, A. A., Maassen, R. L., & Wieringa, P. A. (2012). Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope. Acta Anaesthesiologica Scandinavica, 56(2), 224-9. https://doi.org/10.1111/j.1399-6576.2011.02541.x
Lee RA, et al. Forces Applied to the Maxillary Incisors By Video Laryngoscopes and the Macintosh Laryngoscope. Acta Anaesthesiol Scand. 2012;56(2):224-9. PubMed PMID: 22091734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope. AU - Lee,R A, AU - van Zundert,A A J, AU - Maassen,R L J G, AU - Wieringa,P A, Y1 - 2011/10/14/ PY - 2011/08/23/accepted PY - 2011/11/19/entrez PY - 2011/11/19/pubmed PY - 2012/5/2/medline SP - 224 EP - 9 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 56 IS - 2 N2 - BACKGROUND: Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade. METHODS: Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope(®) (Verathon Inc., Bothell, WA, USA), V-Mac™ Storz(®) (Karl Storz, Tuttlingen, Germany), and McGrath™ (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz(®) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior to the vocal cords, with actual intubation carried out only with the second of the laryngoscopes. Sensors measured the forces directly applied to the patient's maxillary incisors while inserting the ETT. Other common metrics of intubation difficulty (e.g. Mallampati grade, Cormack-Lehane grade, and time) were also recorded. RESULTS: Only one patient was not intubated within the standard study parameters and was converted to the hospital protocols for difficult intubations. The forces applied to the maxillary incisors were significantly greater with the Macintosh blade compared with all VLSs. There were no differences between the VLSs with regard to the forces. Patient characteristics, including Mallampati grade, were not predictive of the forces applied. CONCLUSIONS: All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/22091734/Forces_applied_to_the_maxillary_incisors_by_video_laryngoscopes_and_the_Macintosh_laryngoscope_ L2 - https://doi.org/10.1111/j.1399-6576.2011.02541.x DB - PRIME DP - Unbound Medicine ER -