Radiological Measurement of Cervical Angulation Comparing Direct Laryngoscopy with Miller Blade vs. lightwand
Objective. To compare the cervical spine motion with direct laryngoscopy using the Miller blade with cervical protection, triple maneuver and intubation with lightwand in patients with no predictors of a difficult airway.
Methods. This is a series of 5 female patients who underwent elective embolization of cerebral arteriovenous malformations between January and March 2003, at the Fundación de Santa Fe University Hospital, Bogotá. Videofuoroscopic measurements were taken to determine the angular displacement of the cervical spine.
Results. Rhe study included five female patients with an average age of 43 years. C1 and C5 were the segments with greater displacement. Baseline measurements were taken with the head of the patient in neutral position to compare against subsequent measurements.
Less motion was observed at the segments with greater displacement (C1 y C5) with the use of the lightwand versus direct laryngoscopy with the Miller blade (8° vs. 13.2° at C1 and 6.4° vs. 15.6° at C5). The triple maneuver and the fixation of the endotracheal tube caused less angulation than the intubation maneuver.
Conclusions. Lightwand intubation could be a useful and safe alternative in patients with cervical spine disorders and movement limitations.
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