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

Autor: Şahin T; Department of Anaesthesiology and Critical Care, Kocaeli University School of Medicine, Kocaeli, Turkey., Arslan Zİ; Department of Anaesthesiology and Critical Care, Kocaeli University School of Medicine, Kocaeli, Turkey., Akansel G; Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey., Balaban O; Department of Anaesthesiology and Pain, Dumlupınar University, Kutahya, Turkey., Berk D; Department of Anaesthesiology and Critical Care, Adatıp Hospital, Sakarya, Turkey., Solak M; Department of Anaesthesiology and Critical Care, Kocaeli University School of Medicine, Kocaeli, Turkey., Toker K; Department of Anaesthesiology and Critical Care, İstinye University, İstanbul, Turkey.
Jazyk: angličtina
Zdroj: Turkish journal of anaesthesiology and reanimation [Turk J Anaesthesiol Reanim] 2018 Feb; Vol. 46 (1), pp. 44-50. Date of Electronic Publication: 2018 Feb 01.
DOI: 10.5152/TJAR.2018.53367
Abstrakt: 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.
Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.
Databáze: MEDLINE
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