Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals
Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals
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DOI：
10.1016/j.jclinane.2011.06.015
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发表时间：
2012-03-01
影响因子：
6.7
通讯作者：
Bodner, Scott
中科院分区：
文献类型：
--
作者：
Lebowitz, Philip W.;Shay, Hamilton;Bodner, Scott
研究目的：为了确定肩和头抬高，使患者的耳朵位于胸骨或高于胸骨（“斜坡”），是否改善了不同体重指数（BMI）值的成人患者的喉镜分级。设计：前瞻性，非盲研究，患者和喉镜医师作为自己的对照。设置：一所大学附属医院的手术室。患者：189名阿萨身体状况为1、2和3级的成人患者。干预措施：在进行标准术前气道评估并诱导全身麻醉后，麻醉师进行两次喉镜检查并进行分级：一次在“斜坡”位置，一次在“吸气”位置。测量结果：记录患者BMI、Mallampati气道分级、甲颏距离、颈围、颈部伸展能力、每次喉镜检查的Cormack和Lehane喉镜分级、所需的主观上举力和喉外压力需求。主要结果：使用的“坡道”提供了显着更好的或相等的喉镜视图，相对于那些与“嗅”的位置，在整个studypopulation.Conclusions：肩和头部的任何手段，使患者的胸骨上的水平平面的外耳道保持或改善喉镜视图显着。(C)2012 Elsevier Inc. All rights reserved.
Study Objective: To determine whether shoulder and head elevation, such that the patient's ear lies at or higher than the sternum ("ramp"), improves laryngoscopic grade in adult patients of various body mass index (BMI) values.Design: Prospective, unblinded study, with patients and laryngoscopists acting as their own controls.Setting: Operating room of a university-affiliated hospital.Patients: 189 adult ASA physical status 1, 2, and 3 patients.Interventions: After performing a standard preoperative airway evaluation and inducing general anesthesia, the anesthetist performed and graded two laryngoscopies: one in the "ramp" position and one in the "sniff" position.Measurements: Patient BMI, Mallampati airway class, thyromental distance, neck circumference, cervical extension ability, Cormack and Lehane laryngoscopic grade for each laryngoscopy, subjective lifting force required, and need for external laryngeal pressure were recorded.Main Results: Use of the "ramp" provided significantly better or equal laryngoscopic views, relative to those with the "sniff" position, in the entire study population.Conclusions: Shoulder and head elevation by any means that brings the patient's sternum onto the horizontal plane of the external auditory meatus maintains or improves laryngoscopic view significantly. (C) 2012 Elsevier Inc. All rights reserved.