Laryngeal exposure during laryngoscopy is better in the 25° back-up position than in the supine position

被引:85
作者
Lee, B. J. [1 ]
Kang, J. M. [1 ]
Kim, D. O. [1 ]
机构
[1] Kyung Hee Univ, EW Neo Med Ctr, Dept Anaesthesiol, Seoul 134090, South Korea
关键词
anaesthetic techniques; laryngoscopy; measurement techniques; endoscopy; position; intubation;
D O I
10.1093/bja/aem095
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background. Good visualization of the glottis is important for tracheal intubation. This study evaluated whether the 25 degrees back-up position improves the quality of the laryngeal view during laryngoscopy. Methods. Laryngoscopy with a curved blade was performed on 40 anaesthetized patients. The patients were randomly assigned to two groups. Laryngeal views were captured with a rigid 0 degrees endoscope. Views were recorded for each patient in Group A (n=20) during laryngoscopies performed with the patient lying first in the supine position and then in the 25 degrees back-up position. Laryngeal views for patients in Group B (n=20) were first captured while the patient was in the 25 degrees back-up position and then while the patient was in the flat supine position. An anaesthetist blinded to the position graded the quality of the images using the percentage of glottic opening (POGO) score. Results. Comparing the two positions, mean (SD) POGO scores increased significantly from 42.2 (27.4)% in supine position to 66.8 (27.6)% in 25 degrees back-up position (P < 0.0001). Conclusions. During laryngoscopy, the laryngeal view, as assessed by POGO scores, improves significantly in the 25 degrees back-up position when compared with the flat supine position.
引用
收藏
页码:581 / 586
页数:6
相关论文
共 14 条
[1]   Study of the "sniffing position" by magnetic resonance imaging [J].
Adnet, F ;
Borron, SW ;
Dumas, JL ;
Lapostolle, F ;
Cupa, M ;
Lapandry, C .
ANESTHESIOLOGY, 2001, 94 (01) :83-86
[2]   Randomized study comparing the "sniffing position" with simple head extension for laryngoscopic view in elective surgery patients [J].
Adnet, F ;
Baillard, C ;
Borron, SW ;
Denantes, C ;
Lefebvre, L ;
Galinski, M ;
Martinez, C ;
Cupa, M ;
Lapostolle, F .
ANESTHESIOLOGY, 2001, 95 (04) :836-841
[3]   DIFFICULT LARYNGOSCOPY - OBTAINING THE BEST VIEW [J].
BENUMOF, JL .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1994, 41 (05) :361-365
[4]  
Benumof JL, 1996, AIRWAY MANAGEMENT PR, P267
[5]   Force, torque, and stress relaxation with direct laryngoscopy [J].
Hastings, RH ;
Hon, ED ;
Nghiem, C ;
Wahrenbrock, EA .
ANESTHESIA AND ANALGESIA, 1996, 82 (03) :456-461
[6]   FACTOR-ANALYSIS IN DIFFICULT TRACHEAL INTUBATION - LARYNGOSCOPY-INDUCED AIRWAY-OBSTRUCTION [J].
HORTON, WA ;
FAHY, L ;
CHARTERS, P .
BRITISH JOURNAL OF ANAESTHESIA, 1990, 65 (06) :801-805
[7]   Common practice and concepts in anesthesia: Time for reassessment - Is the sniffing position a "gold standard" for laryngoscopy? [J].
Isono, S .
ANESTHESIOLOGY, 2001, 95 (04) :825-827
[8]  
KAUR S, 1991, CRITICAL CARE MED, P8
[9]   Head-elevated laryngoscopy position: Improving laryngeal exposure during laryngoscopy by increasing head elevation [J].
Levitan, RM ;
Mechem, CC ;
Ochroch, EA ;
Shofer, FS ;
Hollander, JE .
ANNALS OF EMERGENCY MEDICINE, 2003, 41 (03) :322-330
[10]   Bimanual laryngoscopy: A videographic study of external laryngeal manipulation by novice intubators [J].
Levitan, RM ;
Mickler, T ;
Hollander, JE .
ANNALS OF EMERGENCY MEDICINE, 2002, 40 (01) :30-37