Cervical spine motion during flexible bronchoscopy compared with the Lo-Pro GlideScope®

Wong, Daniel M.; Prabhu, Atul; Chakraborty, Santanu; Tan, Guan Hee; Massicotte, Eric M.; Cooper, Richard M.

doi:10.1093/bja/aep002

Cited by 55 publications

(32 citation statements)

References 12 publications

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“…Use of the GVL resulted in significant cervical spine movement relative to baseline at all motion segments examined. This is in agreement with the results of a continuous radiographic study by Wong and colleagues [8], in which the GVL caused greater cervical movement than flexible bronchoscopic intubation. In their hands, examination was performed using the second generation GVL with lower vertical profile in patients without cervical stabilization, and they did not evaluate cervical spine movement during Macintosh laryngoscopy.…”

Section: Discussionsupporting

confidence: 92%

Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope

et al. 2010

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Section: Discussionsupporting

confidence: 92%

Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope

et al. 2010

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“…36 With indirect visualization techniques, such as the AT, Bullard, and Glidescope, the range of reported cervical spine extension at C1-2 is 3 to10.4° with the AT, 2.6 to 4.5° with the Bullard, and 4 to 7° with the Glidescope. 34-39 The impact of the ILMA technique on cervical spine extension at C1-2 has also been reported from less than 1° to 5°. 40-42 …”

Section: Discussionmentioning

confidence: 99%

A Comparison of 4 Airway Devices on Cervical Spine Alignment in Cadaver Models of Global Ligamentous Instability at C1-2

Wendling¹,

Tighe²,

Conrad

et al. 2013

Anesthesia &Amp; Analgesia

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Background The effects of advanced airway management on cervical spine alignment in patients with upper cervical spine instability are uncertain. Methods To examine the potential for mechanical disruption during endotracheal intubation in cadavers with unstable cervical spines, we performed a prospective observational cohort study with three cadaver subjects. We created an unstable, type II odontoid fracture with global ligamentous instability at C1-2 in lightly embalmed cadavers, followed by repetitive intubations with four different airway devices (Airtraq laryngoscope, Lightwand, intubating LMA, and Macintosh laryngoscope) while manual in-line stabilization was applied. Motion analysis data were collected using an electromagnetic device to assess the degree of angular movement in three axes (flexion-extension, axial rotation and lateral bending) during the intubation trials with each device. Intubation was performed by either an emergency medical technician or attending anesthesiologist. Results Overall, 153 intubations were recorded with the four devices. The Lightwand technique resulted in significantly less flexion extension and axial rotation at C1-2 than with the intubating LMA (mean difference in flexion-extension 3.2 degrees [95% CI 0.9 to 5.5], p=0.003; mean difference in axial rotation 1.6 degrees [95% CI 0.3 to 2.8], p=0.01 and Macintosh laryngoscope (mean difference in flexion extension 3.1 degrees [95% CI 0.8 to5.4], p=0.005; mean difference in axial rotation 1.4 degrees [95% CI 0.1 to 2.6], p=0.03. Conclusions In cadavers with instability at C1-2, the Lightwand technique produced less motion than the Macintosh and intubating LMA.

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“…First, the head and neck can be maintained in a neutral position during airway management, and neck flexion and extension can be easily limited. A previous study assessed cervical spine motion in 25 The fiberoptic approach resulted in less cervical movement in the absence of cervical immobilization, a potential advantage not seen in a study comparing a luminous stylet (Trachlight) to FOI in unstable cervical spine subjects with manual in-line stabilization. 26 A second benefit to awake FOI is that protective reflexes can be maintained, thereby reducing the risk of aspiration.…”

Section: Fiberoptic Intubationmentioning

confidence: 99%

Fiberoptic Intubation: An Overview and UpdateDiscussion

2014

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SummaryFiberoptic intubation (FOI) is an effective technique for establishing airway access in patients with both anticipated and unanticipated difficult airways. First described in the late 1960s, this approach can facilitate airway management in a variety of clinical scenarios given proper patient preparation and technique. This paper seeks to review the pertinent technology, clinical techniques, and indications for and complications of its use. The role of FOI in airway management algorithms is discussed. Evidence is presented comparing FOI to other techniques with regard to difficult airway management. In addition, we have reviewed the literature on training processes and skill development in FOI.

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Cervical spine motion during flexible bronchoscopy compared with the Lo-Pro GlideScope®

Abstract: During intubation under general anaesthesia, LP-G resulted in greater cervical movement than FB when no cervical immobilization was used in adults without cervical disease. Airway manoeuvres performed before FB, especially jaw thrust, also resulted in cervical spine movement.

Cited by 55 publications

References 12 publications

Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope

Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope

A Comparison of 4 Airway Devices on Cervical Spine Alignment in Cadaver Models of Global Ligamentous Instability at C1-2

Fiberoptic Intubation: An Overview and UpdateDiscussion

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