Cervical spine motion during tracheal intubation with King Vision™ video laryngoscopy and conventional laryngoscopy: a crossover randomized study

El-Tahan, Mohamed R.; Kenany, Samah El; Khidr, Alaa M; Ghamdi, A. A. Al; Tawfik, Ahmed; Mulhim, Abdullah S Al

doi:10.23736/s0375-9393.17.11913-9

Cited by 20 publications

(19 citation statements)

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“…In previous studies comparing the lifting force during intubation between a direct laryngoscope and a videolaryngoscope, the peak and average lifting forces were significantly reduced by about half when using a videolaryngoscope in patients expected to have either a normal or difficult airway [20][21][22]. With the same context, numerous previous studies comparing cervical spine motion during intubation between direct laryngoscopes and various videolaryngoscopes, have reported significantly smaller cervical spine motion during videolaryngoscopic intubation [6,8,9,11,14,17,18]. Nevertheless, intubation using various videolaryngoscopes produced cervical spine motion of 3-13 • at the occiput-C1 segment even under MILS in previous studies [8,9,11,17].…”

Section: Discussionmentioning

confidence: 95%

“…Therefore, cervical immobilization with a cervical collar or manual in-line stabilization (MILS) is recommended to reduce cervical spine motion during intubation in patients at risk of cervical spine instability [3][4][5]. In addition, other devices, including videolaryngoscopes, lighted stylets, flexible fiberoptic bronchoscopes, and supraglottic airway devices, are commonly used in such patients instead of direct laryngoscopes to facilitate intubation and reduce cervical spine motion during intubation [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Videolaryngoscopes can provide a better laryngeal view than direct laryngoscopes in patients under cervical immobilization [12,13]. Moreover, various videolaryngoscopes are known to produce smaller cervical spine motion during intubation than direct laryngoscopes [6,8,9,11,14]. However, it is inevitable that some degree of cervical spine motion will occur during videolaryngoscopic intubation even under cervical immobilization [6,8,9,11,[14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, various videolaryngoscopes are known to produce smaller cervical spine motion during intubation than direct laryngoscopes [6,8,9,11,14]. However, it is inevitable that some degree of cervical spine motion will occur during videolaryngoscopic intubation even under cervical immobilization [6,8,9,11,[14][15][16][17][18]. This is because the force required to lift the videolaryngoscope causes cervical spine motion during intubation, although it is smaller than the force required to lift the direct laryngoscope [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of External Laryngeal Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under Manual In-Line Stabilization: A Randomized Crossover Trial

Kim

Hur

Yoon

et al. 2021

JCM

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We hypothesized that external laryngeal manipulation would reduce cervical spine motion during video laryngoscopic intubation under manual in-line stabilization by reducing the force required to lift the videolaryngoscope. In this randomized crossover trial, 27 neurointerventional patients underwent two consecutive videolaryngoscopic intubation attempts under manual in-line stabilization. External laryngeal manipulation was applied to all patients in either the first or second attempt. In the second attempt, we tried to reproduce the percentage of glottic opening score obtained in the first attempt. Primary outcomes were cervical spine motion during intubation at the occiput-C1, C1–C2, and C2–C5 segments. The intubation success rate (secondary outcome measure) was recorded. Cervical spine motion during intubation at the occiput-C1 segment was significantly smaller with than without external laryngeal manipulation (7.4° ± 4.6° vs. 11.5° ± 4.8°, mean difference −4.1° (98.33% confidence interval −5.8° to −2.3°), p < 0.001), showing a reduction of 35.7%. Cervical spine motion during intubation at the other segments was not significantly different with versus without external laryngeal manipulation. All intubations were achieved successfully regardless of the application of external laryngeal manipulation. External laryngeal manipulation is a useful method to reduce upper cervical spine motion during videolaryngoscopic intubation under manual in-line stabilization.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of External Laryngeal Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under Manual In-Line Stabilization: A Randomized Crossover Trial

Kim

Hur

Yoon

et al. 2021

JCM

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“…Video-laryngoscopy assisted intubation using PVC or reinforced tubes can be helpful in encountering the difficulties in airway management and the risk of hypoxia due to prolonged apnoea time leading to devastating neurological injury in patients with cervical spine instability. [ 7 8 9 10 11 ] To the best of our knowledge, this is the first study comparing CRT and SRT using KVVL in patients with cervical spine instability. The present study revealed that the average time required for intubation was less with CRT (16.24 ± 3.09 seconds) than SRT (29.08 ± 5.48 seconds) when used through KVVL.…”

Section: Discussionmentioning

confidence: 99%

Tracheal intubation with King Vision video laryngoscope in patients with cervical spine instability—Comparison of straight versus curved reinforced endotracheal tubes

Desai¹,

Patel²

2021

Indian Journal of Anaesthesia

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Background and Aims: King Vision video laryngoscope is commonly used to facilitate intubation in corrective surgery for cervical spine instability patients due to less manipulation. Curved and straight reinforced tracheal tubes are regularly used in this surgery as neck of the patient is likely to be flexed. We aimed to compare intubation characteristics between the curved and straight reinforced tubes through King Vision video laryngoscope in patients to be operated for cervical spine instability with the primary objective being intubation time. Methods: Sixty patients undergoing cervical spine surgery were enroled in this prospective randomised comparative clinical study. All were intubated after applying manual in-line stabilisation of the neck, using either curved (group C) or straight (group S) reinforced endotracheal tubes through King Vision video laryngoscope. The intubation time, number of attempts, incidence of tube impingement with arytenoids/aryepiglottic folds, optimisation manoeuvres required and complications were observed. Unpaired ‘t’ test and Chi-square test were used to analyse the data using MedCalc software, version 12.5. Results: Time taken for intubation was shorter with curved compared to straight reinforced tube (16.24 ± 3.09 vs. 29.08 ± 5.48 seconds, P < 0.0001) The first attempt success rate was higher using curved than straight reinforced tube (93.3% vs. 70%, P = 0.02). Incidences of impingement with arytenoids/ aryepiglottic folds and optimisation manoeuvres required more with the straight reinforced tube. Conclusion: The intubation was fast and with higher first attempt success rate with curved than with straight reinforced tube through King Vision videolaryngoscope when used in patients with cervical spine instability.

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Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

Lewis

Butler

Parker

et al. 2016

Cochrane Database of Systematic Reviews

248

250

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Videolaryngoscopes may reduce the number of failed intubations, particularly among patients presenting with a difficult airway. They improve the glottic view and may reduce laryngeal/airway trauma. Currently, no evidence indicates that use of a VLS reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications, and no evidence indicates that use of a VLS affects time required for intubation.

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Cervical spine motion during tracheal intubation with King Vision™ video laryngoscopy and conventional laryngoscopy: a crossover randomized study

Cited by 20 publications

References 0 publications

Effects of External Laryngeal Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under Manual In-Line Stabilization: A Randomized Crossover Trial

Effects of External Laryngeal Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under Manual In-Line Stabilization: A Randomized Crossover Trial

Tracheal intubation with King Vision video laryngoscope in patients with cervical spine instability—Comparison of straight versus curved reinforced endotracheal tubes

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

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