Is video laryngoscopy easier than direct laryngoscopy for intubation in patients with contracture neck? 2020

Roopali Gupta, and Ameeta Sahni
Department of Anesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

OBJECTIVE Postburn contracture (PBC) of the neck is commonly seen after acute burn in the face and neck region. Managing the airway is a challenge due to functional and anatomical deformities. We compared the ease of intubation using video and direct laryngoscopes. METHODS Eighty patients, 18-60 years of age with ASA physical status I/II with Onah's types 1 and 2 contracture of the neck were randomized in this study. Group DL were intubated by direct laryngoscopy (DL) using Macintosh blade and Group VL by video laryngoscopy (VL) using King Vision. The outcome measures were ease of intubation (EOI), Cormack-Lehane (CL) grading, and associated complications if any. RESULTS EOI score was significantly lower in group VL (0.42 ± 0.84) as compared to group DL (0.85 ± 1.21) (P = 0.048) as was the use of external maneuvers (group VL: 17.5%; group DL: 42.5%; P = 0.015), and the use of stylet (group VL: 0%; group DL: 20%, P = 0.005). CL grading improved significantly in group VL (P < 0.001). Occurrence of complications was negligible in both the groups. A single failure in group DL needed rescue intubation. CONCLUSIONS Intubation with a video laryngoscope was easier than with DL in patients with mild-to-moderate contracture neck with mouth opening >3 cm and MPG I/II.

UI MeSH Term Description Entries

Related Publications

Roopali Gupta, and Ameeta Sahni
February 2013, Anesthesiology,
Roopali Gupta, and Ameeta Sahni
May 2017, JAMA,
Roopali Gupta, and Ameeta Sahni
May 2017, JAMA,
Roopali Gupta, and Ameeta Sahni
May 2017, JAMA,
Roopali Gupta, and Ameeta Sahni
May 2017, JAMA,
Roopali Gupta, and Ameeta Sahni
January 2018, Chest,
Roopali Gupta, and Ameeta Sahni
February 2017, Internal and emergency medicine,
Roopali Gupta, and Ameeta Sahni
January 2016, The Journal of perinatal & neonatal nursing,
Roopali Gupta, and Ameeta Sahni
June 2016, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine,
Roopali Gupta, and Ameeta Sahni
December 2020, Anesthesia progress,
Copied contents to your clipboard!