Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces.

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Joanna K GordonRichard M Cooper

Abstract

Upper airway injury and sympathetic activation may be related to the forces applied during laryngoscopy. We compared the applied forces during laryngoscopy using direct and indirect visualization of a standardized mannequin glottis. Force transducers were applied to the concave surface of a GlideScope T-MAC Macintosh-style video laryngoscope that can also be used as a conventional direct-view laryngoscope. Thirty-four anesthesiologists performed four laryngoscopies (two direct and two indirect views) on an Ambu mannequin in a randomized sequence. During each laryngoscopy, participants were instructed to obtain views corresponding to > 80% and 50% of the glottic opening aperture. Peak and impulse forces were measured for each view. To achieve a 50% glottic opening view, the top 10th percentile force was higher with direct vs indirect laryngoscopy in terms of peak (difference, 9.1 newton; 99% confidence interval [CI], 7.4 to 13.9) and impulse (difference, 56.4 newton·sec; 99% CI, 49.0 to 81.7) forces. To achieve >80% view of the glottic opening, median force was higher with direct vs indirect laryngoscopy in terms of peak (difference, 3.6 newton; 99% CI, 1.6 to 7.3) and impulse (difference, 20.4 newton·sec; 99% CI, 11.7 to 35.1) ...Continue Reading

References

Jul 1, 1991·Acta Anaesthesiologica Scandinavica·H G HassanA Fouda
Mar 1, 1987·British Journal of Anaesthesia·A J ShribmanK J Achola
Sep 1, 1983·British Journal of Anaesthesia·D R DerbyshireG Smith
Oct 29, 1999·Anaesthesia·R M LevitanE A Ochroch
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Sep 11, 2014·British Journal of Anaesthesia·J J PanditUNKNOWN Association of Anaesthetists of Great Britain and Ireland
Jun 20, 2015·British Journal of Anaesthesia·F E KellyT Simpson

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Citations

Jan 29, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Orlando Hung
Jan 14, 2021·Indian Journal of Anaesthesia·A H ShruthiY R Chandrika
Feb 8, 2021·British Journal of Anaesthesia·Rex R D Marks

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