Tracheal Intubation in Patients With Odentogenous Abscesses and Reduced Mouth Opening

Schumann, M.; Biesler, I.; Börgers, A.; Pförtner, Roman; Mohr, Christopher; Groeben, Harald

doi:10.1097/sa.0000000000000060

Cited by 2 publications

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“…Over the last decade, numerous indirect laryngoscopes have been introduced into clinical practice and compared with the Macintosh laryngoscope [1][2][3][4][5][6][7]. Most studies have described a significantly better glottic view and a higher success rate in difficult tracheal intubations for the indirect laryngoscopes.…”

Section: Introductionmentioning

confidence: 99%

Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia

et al. 2015

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SummaryNumerous indirect laryngoscopes have been introduced into clinical practice and their use for tracheal intubation under local anaesthesia has been described. However, a study comparing indirect laryngoscopic vs fibreoptic intubation under local anaesthesia and sedation appears lacking. Therefore, we evaluated both techniques in 100 patients with an anticipated difficult nasal intubation time for intubation the primary outcome. We also assessed success rate, glottic view, Ramsey score, and patients' and anaesthetists' satisfaction. The median (IQR [range]) time for intubation was significantly shorter with the videolaryngoscope with 38 (24-65 [11-420]) s vs 94 (48-323 [19-1020]) s (p < 0.0001). There was no difference in the success rate of intubation (96% for both techniques; p > 0.9999) and satisfaction of the anaesthetists and patients. We conclude that in anticipated difficult nasal intubation a videolaryngoscope represents an acceptable alternative to fibreoptic intubation.

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Section: Introductionmentioning

confidence: 99%

Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia

et al. 2015

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“…In awake patient, restricted mouth opening could be due to disease extending to masticator space, fibrosis (Chronic tobacco chewing, or radiation induced), reflex contraction and pain. In our study mouth opening was improved significantly after induction of anaesthesia and neuromuscular block as evidenced by easy introduction of laryngoscope blade during direct laryngoscopy 9 .So when restricted mouth opening is due to pain and reflex contraction, false high prediction of difficult airway can be achieved on using only MPG and IID as bedside tests. We also tested TMD and neck movements.…”

Section: Discussionmentioning

confidence: 48%

Are Bedside Predictors of Difficult Intubation Really True Indicators in Head and Neck Cancer Patients?

Jain¹,

Gupta²

2020

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BACKGROUND Unanticipated difficult airway can lead to serious morbidity and mortality in Head and Neck cancer surgical patients. We wanted to determine the incidence of difficult laryngoscopy, difficult intubation and their correlation with routine bedside predictors of difficult airway. METHODS In this prospective observational study, 30 patients posted for elective oral and neck cancer surgery were assessed preoperatively and history of addiction, previous head and neck chemoradiation therapy, Mallampati grade, inter-incisor distance, thyromental distance and neck movements were noted. After standard anaesthetic induction, Cormack Lehane Grade was noted on first direct laryngoscopy attempt and intubation difficulty was assessed using intubation difficulty scale on the basis of seven variables. RESULTS Tobacco chewing was found to be a major risk factor for developing H & N cancer in 90% of subjects. Incidence of difficult laryngoscopy was 46.66% and incidence of difficult intubation was 20% in our study. On doing univariate logistic regression analysis, Cormack Lehane grade >=3 was found to have significant correlation with difficult intubation but on assessing independent correlation using multivariate regression analysis, none of the predictors had any significant correlation with difficult intubation. CONCLUSIONS The routine bedside predictors of difficult airway are not accurate indicators of difficult intubation in Head & Neck cancer surgical patients.

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Tracheal Intubation in Patients With Odentogenous Abscesses and Reduced Mouth Opening

Abstract: Comment by Kathryn E. McGoldrick, MD Disclosure: The author declares no conflict of interest. REFERENCE 1. Darshane S, Groom P, Charters P. Responsive contingency planning: a novel system for anticipated difficulty in airway management in dental abscess. Br J Anaesth. 2007;99:898-905.

Cited by 2 publications

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Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia

Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia

Are Bedside Predictors of Difficult Intubation Really True Indicators in Head and Neck Cancer Patients?

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Tracheal Intubation in Patients With Odentogenous Abscesses and Reduced Mouth Opening

Abstract: Comment by Kathryn E. McGoldrick, MD Disclosure: The author declares no conflict of interest. REFERENCE 1. Darshane S, Groom P, Charters P. Responsive contingency planning: a novel system for anticipated difficulty in airway management in dental abscess. Br J Anaesth. 2007;99:898-905.

Cited by 2 publications

References 1 publication

Fibreoptic vs videolaryngoscopic (C-MAC®D-BLADE) nasal awake intubation under local anaesthesia

Fibreoptic vs videolaryngoscopic (C-MAC®D-BLADE) nasal awake intubation under local anaesthesia

Are Bedside Predictors of Difficult Intubation Really True Indicators in Head and Neck Cancer Patients?

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Resources

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Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia

Fibreoptic vs videolaryngoscopic (C-MAC^®D-BLADE) nasal awake intubation under local anaesthesia