| Objective To compare the cervical spine movement during oral endotracheal intubation using the Video laryngoscopes and Macintosh laryngoscopes.Methods We searched the Embase、Cochrane library and MEDLINE for randomized controlled trials comparing any kinds of video laryngoscopes with the Macintosh laryngoscope in live human subjects receiving elective surgery under general anesthesia with oral endotracheal intubation.Inclusion criteria were:Adult patients（Age>18 years old）,ASA classification I-III,receiving non-cardiac elective surgery under general anesthesia with oral endotracheal intubation.Exclusion criteria were:history of spinal injury,spinal tumor spine surgery,spine tuberculosis and spondyloarthritis,limitation of spine movement,malformation of dentition,dentition defect,or unstable teeth,abnormality of oral,throat and glottis anatomy structure caused by history of oropharyngeal surgery or tumor or other complications,limitation of mouth opening,possible difficult airway,patients with high risk of gastric aspiration like patients with gastroesophageal reflux disease,pylorochesis or insufficient fasting,pregnant women,body mass index>30kg/m2..The outcomes were the angles between adjacent levels（occiput and atlas,atlas and the second cervical vertebra,the second cervical vertebra and the third cervical vertebra,the third cervical vertebra and the fourth cervical vertebra）and atlanto-occipital distance（AOD）.Results 16 studies met eligibility criteria.8 of them were excluded for not reporting the mean and standard deviation of angles between adjacent levels.One of the other 8 studies were randomized controlled trail,the others were randomized controlled cross-over trails.Since there is a big difference in study design between randomized controlled trail and randomized controlled cross-over trails,this study only include the 7 randomized controlled cross-over trails（total 161 participants）for pooled analysis.According to the Cochrane Handbook,we used the The Generic Inverse Variance method for pooled analysis.We found that the angles between occiput and atlas,atlas and the second cervical vertebra,the second cervical vertebra and the third cervical vertebra,the third cervical vertebra and the fourth cervical vertebra were significantly less in the video laryngoscopes group than those in Macintosh laryngoscope group（P<0.05）.The AOD were significantly smaller in video laryngoscopes group than in Macintosh laryngoscope group（P<0.05）,which is closer to baseline level.Conclusion The Video laryngoscopes cause less cervical spine movement comparing to conventional Macintosh laryngoscope during oral endotracheal intubation... |
PDF Full Text Request