A comparison of two techniques for inserting the Airtraq™ laryngoscope in morbidly obese patients

• Published in: Anaesthesia 2007-08, Vol.62 (8), p.774-777
• Main Authors: Dhonneur, G., Ndoko, S. K., Amathieu, R., Attias, A., Housseini, L. E. L., Polliand, C., Tual, L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Airway management; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Mass Index; Clinical trials; Comparative analysis; Disposable Equipment; Female; Humans; Hypotheses; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - methods; Laryngoscopes; Male; Medical equipment; Medical sciences; Middle Aged; Mucous Membrane - injuries; Obesity; Obesity, Morbid - therapy; Oropharynx - injuries; Prospective Studies
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2007.05128.x

Summary We postulated that video‐controlled tracheal intubation with the Airtraq™ laryngoscope using the reverse manoeuvre instead of the standard technique of insertion could facilitate the airway management of morbidly obese patients. For the reverse manoeuvre the laryngoscope is inserted 180° opposite to that recommended, and once in place rotated into the conventional pharyngeal position. Eighty (40 lean and 40 morbidly obese) ASA I–III adult patients were randomly allocated to four equal groups to compare the standard technique to the reverse manoeuvre for inserting the Airtraq laryngoscope. Video‐controlled and clinical tracheal intubation characteristics were recorded. The reverse manoeuvre did not influence tracheal intubation characteristics in the group of lean patients. In the group of morbidly obese patients, the standard technique of insertion was not satisfactory in 20% of cases and the reverse manoeuvre facilitated, speeded and secured tracheal intubation.