Comparison of intubating laryngeal mask airway and Bullard laryngoscope for oro-tracheal intubation in adult patients with simulated limitation of cervical movements

A. Nileshwar, A. Thudamaladinne

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endotracheal intubation of such patients. We compared their utility and safety in patients with simulated cervical spine immobility using manual inline stabilization (MILS). Methods: Sixty-two patients, ASA I or II, between 18 and 65 yr, were enrolled in this prospective and randomized study. They were randomly allocated to one of the two groups: Group BL (Bullard laryngoscope) and Group IL (Intubating Laryngeal Mask Airway). The patients were intubated orally using either equipment after induction of general anaesthesia. Results: The success rate for intubation in the first or second attempt was higher in Group BL [90.32% (28/31)] than in Group IL [74.2% (23/31)] but was not statistically significant. The number of attempts taken for intubation and the total time to intubate were similar between the groups. Trauma as evidenced by blood on endotracheal tube or sore throat was similar in both groups. Conclusions: Both the BL and the ILMA are useful equipment in intubating patients with limitation of cervical movements. Although not statistically significant, the BL may provide a higher success rate of intubation when compared with the ILMA.

Original languageEnglish
Pages (from-to)292-296
Number of pages5
JournalBritish Journal of Anaesthesia
Volume99
Issue number2
DOIs
Publication statusPublished - 01-08-2007

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Laryngoscopes
Laryngeal Masks
Intubation
Spine
Interleukin-23
Equipment and Supplies
Intratracheal Intubation
Pharyngitis
Patient Safety
General Anesthesia
Prospective Studies
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "Comparison of intubating laryngeal mask airway and Bullard laryngoscope for oro-tracheal intubation in adult patients with simulated limitation of cervical movements",
abstract = "Background: Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endotracheal intubation of such patients. We compared their utility and safety in patients with simulated cervical spine immobility using manual inline stabilization (MILS). Methods: Sixty-two patients, ASA I or II, between 18 and 65 yr, were enrolled in this prospective and randomized study. They were randomly allocated to one of the two groups: Group BL (Bullard laryngoscope) and Group IL (Intubating Laryngeal Mask Airway). The patients were intubated orally using either equipment after induction of general anaesthesia. Results: The success rate for intubation in the first or second attempt was higher in Group BL [90.32{\%} (28/31)] than in Group IL [74.2{\%} (23/31)] but was not statistically significant. The number of attempts taken for intubation and the total time to intubate were similar between the groups. Trauma as evidenced by blood on endotracheal tube or sore throat was similar in both groups. Conclusions: Both the BL and the ILMA are useful equipment in intubating patients with limitation of cervical movements. Although not statistically significant, the BL may provide a higher success rate of intubation when compared with the ILMA.",
author = "A. Nileshwar and A. Thudamaladinne",
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N2 - Background: Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endotracheal intubation of such patients. We compared their utility and safety in patients with simulated cervical spine immobility using manual inline stabilization (MILS). Methods: Sixty-two patients, ASA I or II, between 18 and 65 yr, were enrolled in this prospective and randomized study. They were randomly allocated to one of the two groups: Group BL (Bullard laryngoscope) and Group IL (Intubating Laryngeal Mask Airway). The patients were intubated orally using either equipment after induction of general anaesthesia. Results: The success rate for intubation in the first or second attempt was higher in Group BL [90.32% (28/31)] than in Group IL [74.2% (23/31)] but was not statistically significant. The number of attempts taken for intubation and the total time to intubate were similar between the groups. Trauma as evidenced by blood on endotracheal tube or sore throat was similar in both groups. Conclusions: Both the BL and the ILMA are useful equipment in intubating patients with limitation of cervical movements. Although not statistically significant, the BL may provide a higher success rate of intubation when compared with the ILMA.

AB - Background: Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endotracheal intubation of such patients. We compared their utility and safety in patients with simulated cervical spine immobility using manual inline stabilization (MILS). Methods: Sixty-two patients, ASA I or II, between 18 and 65 yr, were enrolled in this prospective and randomized study. They were randomly allocated to one of the two groups: Group BL (Bullard laryngoscope) and Group IL (Intubating Laryngeal Mask Airway). The patients were intubated orally using either equipment after induction of general anaesthesia. Results: The success rate for intubation in the first or second attempt was higher in Group BL [90.32% (28/31)] than in Group IL [74.2% (23/31)] but was not statistically significant. The number of attempts taken for intubation and the total time to intubate were similar between the groups. Trauma as evidenced by blood on endotracheal tube or sore throat was similar in both groups. Conclusions: Both the BL and the ILMA are useful equipment in intubating patients with limitation of cervical movements. Although not statistically significant, the BL may provide a higher success rate of intubation when compared with the ILMA.

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