Forces Applied to the Maxillary Incisors During Video-Assisted Intubation

Lee, Ruben A., van Zundert, Andre A. J., Willems, Remi J., Maassen, Ralph L. J. G., Beeke, Leon P., Schaaper, Jan N., van Dobbelsteen, Johan and Wieringa, Peter A. (2008) Forces Applied to the Maxillary Incisors During Video-Assisted Intubation. Anesthesia and Analgesia, 108 1: 187-191.

Author Lee, Ruben A.
van Zundert, Andre A. J.
Willems, Remi J.
Maassen, Ralph L. J. G.
Beeke, Leon P.
Schaaper, Jan N.
van Dobbelsteen, Johan
Wieringa, Peter A.
Title Forces Applied to the Maxillary Incisors During Video-Assisted Intubation
Journal name Anesthesia and Analgesia   Check publisher's open access policy
ISSN 0003-2999
Publication date 2008
Year available 2008
Sub-type Critical review of research, literature review, critical commentary
Open Access Status
Volume 108
Issue 1
Start page 187
End page 191
Total pages 5
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Language eng
Formatted abstract
BACKGROUND:: Modern, video laryngoscopes provide an easier view of the glottis, possibly facilitating easier intubations. We describe an objective method for evaluating the benefits of video-assisted laryngoscopy, compared with standard techniques using force measurements.

METHOD:: Macintosh and video laryngoscopes (both Karl Storz, Tuttlingen, Germany) were used on the patients until the anesthesiologist was convinced he or she had the best possible view of the glottis. Actual intubation was only performed with the second of the laryngoscopes. Sensors measured the forces directly applied to the patients' maxillary incisors. Additionally, common subjective pre- (e.g., Mallampati) and intraintubation (e.g., Cormack-Lehane [C&L]) metrics of intubation difficulty were evaluated by the anesthesiologists.

RESULTS:: All patients (24 female, [50 ± 16 yr], 20 male [56 ± 13 yr]) included in the study were successfully intubated with both the classic and video laryngoscopes. The forces recorded for the classic Macintosh blade ranged from 0 to 87.4 N with a median of 15.3 N, whereas the video laryngoscope forces ranged from 0 to 45.2 N, with a median of 2.1 N. The only factor determined to be significantly influential on the associated forces applied to the maxillary incisors was the laryngoscope type (P < 0.01). Video-assisted laryngoscopes reduced the applied forces over standard blades. Mallampati and C&L grade were not predictive of the forces applied.

CONCLUSIONS:: Video-assisted laryngoscopes seem beneficial when considering forces applied to the maxillary incisors as an objective metric of intubation difficulty. In this study, we could not support that Mallampati and C&L grades predict the forces that are applied to the maxillary incisors.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 32 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 43 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 21 May 2015, 08:08:53 EST by Andre Van Zundert on behalf of Anaesthesiology and Critical Care - RBWH