RESUMO
BACKGROUND AND OBJECTIVE: The AirTraq laryngoscope is a new intubation device that may provide better viewing conditions than can be achieved with the traditional Macintosh device. This study compared the AirTraq and Macintosh views and assessed whether predictors of intubation difficulty are useful when the AirTraq laryngoscope is used. MATERIAL AND METHODS: Prospective study of 215 ASA 1-3 patients over the age of 18 years who were to receive anesthesia with endotracheal intubation. Excluded were patients who required emergency surgery, who had a history of difficult intubation, or for whom ventilation was difficult during induction of anesthesia. In addition to the usual patient characteristics, we recorded thyromental distance, mouth opening, and Mallampati score. The Cormack-Lehane laryngoscopy grade was recorded for each device. A Cormack-Lehane grade of 1 or 2 was considered a good view. A grade of 3 or 4 was considered a poor view. The McNemar test was used to compare laryngoscopy grade between the 2 devices in each patient. The chi2 test was used to compare predictors of intubation difficulty. RESULTS: The Macintosh laryngoscope achieved a Cormack-Lehane grade of 1 in 653% of the patients, of 2 in 22.4%, of 3 in 11.3%, and of 4 in 1.4%. The AirTraq scope gave a Cormack-Lehane grade of 1 in 96.2%, of 2 in 33%, of 3 in 0.5%, and of 4 in 0%. The differences were statistically significant. None of the predictors was associated a poor glottic view through the AirTraq device. CONCLUSIONS: Poor viewing conditions occurred less frequently when the AirTraq device was used. Intubation conditions were therefore better with the AirTraq than with the Macintosh device. The traditional predictors of difficult intubation do not seem to be relevant when the AirTraq device is to be used.
Assuntos
Glote/anatomia & histologia , Laringoscópios , Antropometria , Procedimentos Cirúrgicos Eletivos , Desenho de Equipamento , Feminino , Humanos , Intubação Intratraqueal , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
INTRODUCCIÓN: El laringoscopio Airtraq es un nuevodispositivo de intubación que puede proporcionar mejorescondiciones de visión frente al clásico Macintosh. Secompara la diferencia en la laringoscopia entre ambos:Airtraq y Macintosh; así como si los predictores de intubaciónson útiles para el Airtraq.MATERIAL Y MÉTODOS: Estudio prospectivo incluyendo215 pacientes, mayores de 18 años, ASA I-III, sometidosa anestesia con intubación endotraqueal. Se excluyóla cirugía urgente, los que habían presentado unaintubación difícil en episodios previos y la dificultad enla ventilación durante la inducción de anestesia. Seestudiaron los datos demográficos, antropométricos,distancia tiromentoniana, apertura bucal, Mallampatiy grado de visión laringoscópica Cormack-Lehane concada dispositivo. Se clasificó a los pacientes según sugrado de Cormack-Lehane como buena visión si lavisión era I o II y mala visión si era III o IV. Se utilizóla prueba de McNemar para comparar el grado devisión laringoscópica de ambos dispositivos en cadapaciente y ji-cuadrado en el caso de los predictores deintubación.RESULTADOS: La distribución según la visión laringoscópicacon Macintosh fue: Cormack-Lehane I 65,3%, II22,4%, III 11,3% y IV 1,4% y con Airtraq Cormack-Lehane I 96,2%, II 3,3%, III 0,5% y IV ninguno. Estasdiferencias fueron estadísticamente significativas. Ni ladistancia tiromentoniana, ni la apertura bucal, ni el gradode Mallampati se asociaron una mala visión laringoscópicacon Airtraq.CONCLUSIONES: El dispositivo Airtraq disminuyó elnúmero de laringoscopias con mala visión y como consecuenciaproporcionó mejores condiciones de intubaciónen relación al Macintosh. Además los predictores deintubación clásicos no parecieron tener utilidad cuandose utiliza el Airtraq(AU)
BACKGROUND AND OBJECTIVE: The AirTraqlaryngoscope is a new intubation device that mayprovide better viewing conditions than can be achievedwith the traditional Macintosh device. This studycompared the AirTraq and Macintosh views andassessed whether predictors of intubation difficulty areuseful when the AirTraq laryngoscope is used.MATERIAL AND METHODS: Prospective study of 215ASA 1-3 patients over the age of 18 years who were toreceive anesthesia with endotracheal intubation.Excluded were patients who required emergencysurgery, who had a history of difficult intubation, or forwhom ventilation was difficult during induction ofanesthesia. In addition to the usual patientcharacteristics, we recorded thyromental distance,mouth opening, and Mallampati score. The Cormack-Lehane laryngoscopy grade was recorded for eachdevice. A Cormack-Lehane grade of 1 or 2 wasconsidered a good view. A grade of 3 or 4 was considereda poor view. The McNemar test was used to comparelaryngoscopy grade between the 2 devices in eachpatient. The 2 test was used to compare predictors ofintubation difficulty.RESULTS: The Macintosh laryngoscope achieved aCormack-Lehane grade of 1 in 65.3% of the patients, of2 in 22.4%, of 3 in 11.3%, and of 4 in 1.4%. The AirTraqscope gave a Cormack-Lehane grade of 1 in 96.2%, of 2in 3.3%, of 3 in 0.5%, and of 4 in 0%. The differenceswere statistically significant. None of the predictors wasassociated a poor glottic view through the AirTraq device. CONCLUSIONS: Poor viewing conditions occurred lessfrequently when the AirTraq device was used.Intubation conditions were therefore better with theAirTraq than with the Macintosh device. The traditionalpredictors of difficult intubation do not seem to berelevant when the AirTraq device is to be used(AU)
Assuntos
Humanos , Laringoscópios , Laringoscopia/métodos , Intubação Intratraqueal/instrumentação , Estudos Prospectivos , Anestesia/métodosRESUMO
The preventive measures of bicycle accidents in children, depends on the knowledge of the risk of use of the bicycle by children. In our study, over 50% of severe bicycle accidents had CNS trauma, pointing the need of brain protection. In view of our experience we recommend the teaching of the rules of circulation to children and the necessity of periodic bicycle revisions.
