Volume 4 Supplement 1

20th International Symposium on Intensive Care and Emergency Medicine

Open Access

A comparison of the effects of conventional and balloon laryngoscopy on the sagittal dimensions of the space available for the cord at the level of the occipitoatlantoaxial complex

  • SD Mentzelopoulos1,
  • MJ Tzoufi1 and
  • EP Papageorgiou1
Critical Care20004(Suppl 1):P103

DOI: 10.1186/cc823

Published: 21 March 2000

Full text

Background

The purpose of this study was to compare the sagittal surface areas (SSAs) of the space available for the cord (SAC) at the occiput (OCC)-first cervical vertebra (C1) and C1-C2 levels determined at neutral head position, and during conventional and balloon laryngoscopy [1,2].

Methods

Anesthesia was induced in eight ASA I, Mallampati I, elective surgery patients. Cross-table lateral-view radiographs were taken at neutral head position (NHP) and upon maximal laryngeal exposure (MLE) with a #4 standard and a #4 modified blade carrying two 10 Foley catheters. MLE during balloon laryngoscopy was achieved by right catheter-balloon inflation with 2 ml air and blade-elevation [1,2]. The radiographs were scanned in Photoshop 5.0, the X-ray magnification was determined, and the OCC-C1 and C1-C2 SAC-SSAs were measured with Autocad 2000. The OCC-C1-SAC and C1-C2-SAC anatomic landmarks are shown in Fig.1. Data were analyzed with Kolmogorov-Smirnov test and ANOVA.

Results

At the OCC-C1 level, the SAC-SSA was significantly reduced during conventional laryngoscopy (MLE-value =0.386± 0.104 in2, NHP-value =0.501± 0.11 in2, P=0.0095). During balloon laryngoscopy, there was no significant SAC-SSA reduction (MLE-value =0.423± 0.128 in2, P=0.07 vs NHP-value), while the SAC-SSA was significantly greater than the SAC-SSA determined during conventional laryngoscopy (P=0.044). At the C1-C2 level, the SAC-SSA-changes were nonsignificant.

Conclusions

The OCC-C1-SAC is significantly less affected by balloon laryngoscopy.
Figure 1

ABC= inferior margin of occiput. DE=C1-spinous process base. E=most caudal point of C1-spinous process base. F=radiographic intersection of C1 by odontoid-posterior cortex. G=most cephalad point of odontoid-posterior cortex. HI=C2-spinous process base. I=most caudal point of C1-spinous process base. FJ=posterior cortex of C2-vertebral body

Authors’ Affiliations

(1)
Department of Anesthesiology of Egion General Hospital

References

  1. Mentzelopoulos SD, et al.: . Anesth Analg 1999, 88: 1425-1426. 10.1097/00000539-199906000-00051PubMedGoogle Scholar
  2. Mentzelopoulos SD, et al.: . Critical Care 1999, 3(suppl 1): 3-4.Google Scholar

Copyright

© Current Science Ltd 2000

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