Effect of Cricoid Pressure on Laryngeal View During Macintosh, McGrath MAC X-Blade and GlideScope Video Laryngoscopies

Arslan, Zehra İpek; Solak, Mustafa

doi:10.5152/tjar.2017.57778

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…They attributed the midline approach and angle of blade with GlideScope as the reason for this significance. [18] Similarly, in our study, the insertion of KVL was good (57.9%) but the number of attempts for first time insertion was less in Group CP (71.1% in Group C and 57.9% in Group CP). Optimization maneuvers of KVL blade (right/left tilt and/or withdrawal or lift upwards) were also required in 57.9% patients in Group CP.…”

Section: Discussionsupporting

confidence: 74%

“…[17] On applying CP, the CL grade did not change or improve in Macintosh, Mc Grath and C MAC X blade, but worsened with GlideScope ( P < 0.001). [18] In contrast, Corda et al showed that the laryngeal view grade did not change with GlideScope but significantly decreased the glottic area by forcing vocal cord opposition. The use of jaw thrust as a first-line maneuver to aid in glottic visualization and tracheal intubation during GlideScope video laryngoscopy was thus recommended.…”

Section: Discussionmentioning

confidence: 99%

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Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope

et al. 2019

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Context: To establish the usefulness of King Vision ® video laryngoscope (KVL) in patients with rapid sequence anesthesia. Aims: This study aims to compare the role of KVL on glottic visualization, intubation time and associated sympathetic response in routine intubations to those intubations done with cricoid pressure (CP). Settings and Design: Randomized controlled study in a tertiary care hospital. Methodology: Seventy-six patients intubated with KVL were randomized to two groups – Group C (who did not receive any CP) and Group CP – who received CP. The percentage of glottic opening (POGO), intubation time, subjective assessment, and number of attempts taken to introduce KVL and endotracheal tube (ETT) were noted. The saturation, end-tidal carbon dioxide concentration and hemodynamic response (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and rate pressure product) in the peri-intubation period were also recorded. Results: The demographics, airway, and technical characteristics of insertion of KVL and ETT were comparable between the groups ( P > 0.05). POGO score was 100% in both groups. The significant time in insertion of KVL (Group C 29.87 ± 11.64 s and Group CP 40.68 ± 18.93 s, P = 0.004) and ETT (Group C 17.53 ± 8.71 s and Group CP 22.42 ± 10.77 s, P = 0.033) contributed to prolonged overall intubation time in CP (Group C 41.11 ± 11.65 s and Group CP 51.05 ± 17.31 s, P = 0.005). The intergroup and intragroup hemodynamic variables did not show any statistical significance ( P > 0.05) over time. Conclusion: Although overall intubation time with KVL is prolonged in patients with CP, it provides excellent glottic view, eases intubation, and causes insignificant hemodynamic variation.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope

et al. 2019

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“…Cricoid pressure also improves the Cormack-Lehane grade of the McGrath MAC. In this trial, as with our study, the McGrath MAC provides equal intubation times (approximately 13 s) in nonobese patients with the Macintosh and minimal hemodynamic changes compared to other VLs with the help of some key maneuvers [27]. We also used the cricoid pressure maneuver to facilitate tube insertion through the vocal cords.…”

Section: Discussionmentioning

confidence: 95%

“…We based our sample size according to Yumul et al [12]. They used the McGrath MAC in morbidly obese patients and they found the total intubation time to be 62 ± 31 s. Lee et al [13] used the McGrath MAC in normal patients and found the total intubation time of nonobese patients to be 32 (27)(28)(29)(30)(31)(32)(33)(34)(35) s. Based on this data, for a = 0.05 and b = 0.2 we calculated our sample size as 40 patients in each group. Continuous data were examined for normal distribution with the Kolmogorov-Smirnov test.…”

Section: Total Orotracheal Intubation Timementioning

confidence: 99%

Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Arslan¹,

Yörükoğlu²

2019

Turk J Med Sci

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Background/aim: Increased body mass index (BMI) and neck circumference are the two independent predictors of difficult intubation. McGrath MAC X-Blade is a videolaryngoscope specifically designed for difficult intubations. Materials and methods: Eighty patients with the American Society of Anesthesiologists (ASA) physical status I-III undergoing elective surgery requiring endotracheal intubation were enrolled in the study. Patients were divided into two groups, nonobese (BMI < 30) and morbidly obese (BMI > 35). All patients were intubated with the McGrath MAC X-Blade in both groups. View optimization and tube insertion maneuvers such as reinsertion of the device, slight removal of the device, cricoid pressure, handling force, 90° anticlockwise rotation of the tube, use of stylet, and head flexion maneuvers were recorded. Cormack-Lehane grades, insertion times, intubation, and total intubation times were recorded. The hemodynamic changes and postoperative minor complications were also recorded. Results: Body mass index, neck circumference, Mallampati scores, and ASA physical status were statistically higher in the morbidly obese group (P < 0.001 and P < 0.05). Sternomental distances were shorter in the morbidly obese (P < 0.05). Cormack-Lehane grades were comparable among the groups. The morbidly obese patients required more reinsertion attempts and cricoid pressure maneuvers during intubation than the nonobese patients (P = 0.019 versus P = 0.012, respectively). Slight removal of the device, handling force, use of the stylet, 90° anticlockwise rotation of the tube, and head flexion maneuvers were also helpful in both groups. Although device insertion times were similar between the groups, intubation and total intubation times were longer in the morbidly obese group (P = 0.009 and P = 0.034, respectively). The groups were comparable in hemodynamic changes and postoperative minor complications. Conclusion: The McGrath MAC X-Blade videolaryngoscope could safely be used both in nonobese (BMI < 30) and morbidly obese (BMI > 35) patients with the aid of some key maneuvers and with a statistically significant but clinically negligible prolongation of the intubation time.

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“…There are studies showing that CP may impair the airway during intubation . However, some studies have shown the opposite . Unfortunately, both anesthesiologists and anesthesia nurses often do apply the CP incorrectly, and are pressing on parts of the neck other than the cricoid cartilage .…”

Section: Discussionmentioning

confidence: 99%

Pressure measurement in the upper esophagus during cricoid pressure: A high‐resolution solid‐state manometry study

Pellrud

Ahlstrand

2018

Acta Anaesthesiol Scand

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This study using high-resolution solid-state manometry under clinically relevant conditions shows that 30 N cricoid pressure generates high pressure in the area of the UES, far exceeding the levels previously considered necessary to prevent regurgitation. Additional studies are needed to clarify the effectiveness of cricoid pressure in preventing passive regurgitation before it is rejected as a part of rapid sequence induction.

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Effect of Cricoid Pressure on Laryngeal View During Macintosh, McGrath MAC X-Blade and GlideScope Video Laryngoscopies

Cited by 9 publications

References 21 publications

Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope

Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope

Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Pressure measurement in the upper esophagus during cricoid pressure: A high‐resolution solid‐state manometry study

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Effect of Cricoid Pressure on Laryngeal View During Macintosh, McGrath MAC X-Blade and GlideScope Video Laryngoscopies

Cited by 9 publications

References 21 publications

Effect of cricoid pressure on the glottic view and intubation with king vision® video laryngoscope

Effect of cricoid pressure on the glottic view and intubation with king vision® video laryngoscope

Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Pressure measurement in the upper esophagus during cricoid pressure: A high‐resolution solid‐state manometry study

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Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope

Effect of cricoid pressure on the glottic view and intubation with king vision^® video laryngoscope