Item type:Doctoral Thesis, Open Access

Prospektive, randomisierte, kontrollierte Studie zur Messung der Halswirbelsäulenreklination bei der Laryngoskopie zur endotrachealen Intubation mittels konventioneller Laryngoskopie und Videolaryngoskopie

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Date

2011-08-08

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Philipps-Universität Marburg
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Abstract

Objective: Unconscious patients with severe trauma often require urgent endotra-cheal intubation. During intubation of trauma victims with possible cervical spine injury any movement of head and neck should be avoided. The use of the modern videolaryngoscopy is up-to-date controversially discussed in this connection. This study investigated the influence of videolaryngoscopy with GlideScope® on cervical spine movement during intubation compared with conventional laryngoscopy in an-aesthetized patients with unsecured cervical spine. A noninvasive measuring method was used for the first time. Methods: Therefore a clinical, prospektive, randomized, controlled study with 60 patients with general anaesthesias (Mallampati 1-3) was carried out. After induction of anaesthesia intubation was performed either with videolaryngoscopy (GlideScope®) (NMac=30) or conventional laryngoscopy (Macintosh) (NMac=30). Us-ing a videomotion analysis with a lateral view the maximum extension angle Alpha (main angle), Beta, Gamma and Delta were detected referring to defined anatomical points. Maximum extension angle and successful intubation were measured depend-ing on professional experience and method experience. Maximum angle deviation was measured and analyzed using Mann Whitney U-test. Results: Maximum deviation of mean angle Alpha (angle between baseline and a line drawn from Processus mastoideus to Os frontale; Glabella) was 11.8° in the videolaryngoscope group and 14.3° in the conventional group (p=0.045), with a maximum of 19.2° (videolaryngoscopy) vs. 29.3° (conventional). Intubation by phy-sicians experienced in videolaryngoscopy was associated with reduced angel deviation (α=10.3°) compared to inexperienced (12.8°, p = 0.019). In three patients random-ized to the conventional group (10%) conventional intubation failed but could be successfully performed using videolaryngoscopy. The results of angle delta con-firmed the results of the main angle Alpha, but unfortunately the further angle Beta and Gamma could not show this result. Conclusion: Videolaryngoscopy reduces movement of cervical spine in patients with unsecured cervical spine and therefore might reduce the risk of secondary dam-age during emergency intubation of patients with cervical spine trauma.

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Dates
Created: 2011Issued: 2011-08-08Updated: 2011-08-08
DOI
https://doi.org/10.17192/z2011.0450
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
HalswirbelsäulenreklinationCervical Spine MovementVideolaryngoscopyVideolaryngoskopieHWS-TraumaCervical Spine Injury
DFG-subjects
LaryngoskopieEndotracheale IntubationHalswirbelsäulenverletzung
DDC-Numbers
610
License
https://rightsstatements.org/vocab/InC-NC/1.0/
URI
https://open.uni-marburg.de/handle/10.17192/z2011.0450
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Riße, Joachim: Prospektive, randomisierte, kontrollierte Studie zur Messung der Halswirbelsäulenreklination bei der Laryngoskopie zur endotrachealen Intubation mittels konventioneller Laryngoskopie und Videolaryngoskopie. : Philipps-Universität Marburg 2011-08-08. DOI: https://doi.org/10.17192/z2011.0450.

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