Journals / Turkish Journal of Medical Sciences / 2019 / Cilt: 49 - Sayı: 6

Radiographic comparison of cervical spine motion using LMA Fastrach, LMA CTrach, and the Macintosh laryngoscope

Pages
1681–1686
Publication Date
2022-11-05
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The rate ofsuccessful intubation was 80% with LMA Fastrach and 100% with both LMA CTrach and the Macintosh laryngoscopes.Conclusion: The LMA CTrach laryngoscopy involves less upper C-spine movement than the LMA Fastrach and does not increase theduration of the intubation period.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/aim: The optimal technique for airway management in patients with cervical pathology remains unclear.
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Key Findings & Data:The present study aimed to determine upper C-spine movements by radiography during intubationwith different devices as well as comparing the duration and success of intubation in cervical surgery.Materials and methods: Sixty patients scheduled for elective cervical surgery were registered in this prospective, randomized study.Patients with cervical trauma/injury, previous neck surgery, and body mass index (BMI) of >35 kg/m2 were excluded.
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Conclusion & Impact:The rate ofsuccessful intubation was 80% with LMA Fastrach and 100% with both LMA CTrach and the Macintosh laryngoscopes.Conclusion: The LMA CTrach laryngoscopy involves less upper C-spine movement than the LMA Fastrach and does not increase theduration of the intubation period.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Background/aim: The optimal technique for airway management in patients with cervical pathology remains unclear. Intubatinglaryngeal mask airway devices such as LMA CTrach and LMA Fastrach have not been compared for cervical spine (C-spine) movementsin the context of cervical pathology. The present study aimed to determine upper C-spine movements by radiography during intubationwith different devices as well as comparing the duration and success of intubation in cervical surgery.Materials and methods: Sixty patients scheduled for elective cervical surgery were registered in this prospective, randomized study.Patients with cervical trauma/injury, previous neck surgery, and body mass index (BMI) of >35 kg/m2 were excluded. Participants wererandomized to one of the 3 groups: LMA CTrach, LMA Fastrach, or the Macintosh laryngoscope. C-spine motion was evaluated bymeasuring angles created by bordering vertebrae at cervical 1/2 and 2/3 (C1/2, C2/3) segments on 2 lateral cervical radiographs for eachpatient. Intubation time, ease of intubation, number of attempts, and success rate were also documented.Results: Demographic data were similar in all the groups. The cervical movement with LMA CTrach and LMA Fastrach compared tothe Macintosh laryngoscope were similar at C1/2. However, LMA CTrach significantly reduced extension compared to LMA Fastrachand Macintosh laryngoscopes at C2/3. Duration of intubation was significantly shorter with the Macintosh laryngoscope. The rate ofsuccessful intubation was 80% with LMA Fastrach and 100% with both LMA CTrach and the Macintosh laryngoscopes.Conclusion: The LMA CTrach laryngoscopy involves less upper C-spine movement than the LMA Fastrach and does not increase theduration of the intubation period.

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Cite This Article

BEDİRLİ, N., ŞATIRLAR, Z. Ö., İNAN, G. (2022). Radiographic comparison of cervical spine motion using LMA Fastrach, LMA CTrach, and the Macintosh laryngoscope. Turkish Journal of Medical Sciences, Cilt: 49 - Sayı: 6, 1681–1686. https://ajindex.com/articles/610082

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References (12)

  1. Duggan LV, Griesdale DE. Secondary cervical spine injury during airway management: beyond a ‘one-size-fits-all’ approach. Anaesthesia 2015
  2. 70 (7): 769-773. doi: 10.1111/ anae.13163 2. Farag E. Airway management for cervical spine surgery. Best Practice & Research Clinical Anaesthesiology 2016
  3. 30 (1): 13- 25. doi: 10.1016/j.bpa.2016.01.001 3. Prasarn ML, Conrad B, Rubery PT, Wendling A, Aydog T et al. Comparison of 4 airway devices on cervical spine alignment in a cadaver model with global ligamentous instability at C5-C6. Spine 2012
  4. 37 (6): 476-481. doi: 10.1097/ BRS.0b013e31822419fe 4. Sawin PD, Todd MM, Traynelis VC, Farrell SB, Nader A et al. Cervical spine motion with direct laryngoscopy and orotracheal intubation: an in vivo cinefluoroscopic study of subjects without cervical abnormality. Anesthesiology 1996
  5. 85 (1): 26-36. 5. Suppan L, Tramèr MR, Niquille M, Grosgurin O, Marti C. Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials. British Journal of Anaesthesia 2016
  6. doi: 10.1093/ bja/aev205 6. Sahin A, Salman MA, Erden IA, Aypar U. Upper cervical vertebrae movement during intubating laryngeal mask, fibreoptic and direct laryngoscopy: a video-fluoroscopic study. European Journal of Anaesthesiology 2004
  7. 21 (10): 819-823. 7. Liu EHC, Goy RWL, Chen FG. The LMA CTrachTM, a new laryngeal mask airway for endotracheal intubation under vision: evaluation in 100 patients. British Journal of Anaesthesia 2006
  8. doi: 10.1097/ALN.0b013e31819b62c7 8. Liu EH, Wender R, Goldman AJ. The LMA CTrach™ in Patients with Difficult Airways. Anesthesiology 2009
  9. Kılıç T, Goksu E, Durmaz D, Yıldız G. Upper cervical spine movement during intubation with different airway devices. American Journal of Emergency Medicine 2013
  10. 31 (7): 1034- 1036. doi: 10.1016/j.ajem.2013.03.029 10. Kihara S, Watanabe S, Brimacombe J, Taguchi N, Yaguchi Y et al. Segmental cervical spine movement with the intubating laryngeal mask during manual in-line stabilization in patients with cervical pathology undergoing cervical spine surgery. Anesthesia & Analgesia 2000
  11. Waltl B, Melischek M, Schuschnig C, Kabon B, Erlacher W et al. Tracheal intubation and cervical spine excursion: direct laryngoscopy vs. intubating laryngeal mask. Anaesthesia 2001
  12. Wendling AL, Tighe PJ, Conrad BP, Baslanti TO, Horodys