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Am J Emerg Med. 2018 Jan;36(1):120-123. doi: 10.1016/j.ajem.2017.09.050. Epub 2017 Sep 28.

Effect of the Macintosh curved blade size on direct laryngoscopic view in edentulous patients.

Author information

1
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Republic of Korea.
2
Department of Anesthesiology & Pain Medicine, Seoul National University Bundang Hospital, Republic of Korea.
3
Department of Anesthesiology & Pain Medicine, Seoul National University Hospital, Republic of Korea.
4
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Republic of Korea. Electronic address: marine0@snu.ac.kr.

Abstract

OBJECTIVE:

In the present study, we compared the laryngoscopic view depending on the size of the Macintosh curved blade in edentulous patients.

METHODS:

Thirty-five edentulous adult patients scheduled for elective surgery were included in the study. After induction of anesthesia, two direct laryngoscopies were performed alternately using a standard-sized Macintosh curved blade (No. 4 for men and No. 3 for women) and smaller-sized Macintosh curved blade (No. 3 for men and No. 2 for women). During direct laryngoscopy with each blade, two digital photographs of the lateral view were taken when the blade tip was placed in the valleculae; the laryngoscope was lifted to achieve the best laryngeal view. Then, the best laryngeal views were assessed using the percentage of glottic opening (POGO) score. On the photographs of the lateral view of direct laryngoscopy, the angles between the line extending along the laryngoscopic handle and the horizontal line were measured.

RESULTS:

The POGO score was improved with the smaller-sized blade compared with the standard-sized blade (87.3% [11.8%] vs. 71.3% [20.0%], P<0.001, respectively). The angles between the laryngoscopic handle and the horizontal line were greater with the smaller-sized blade compared to the standard-sized blade when the blade tip was placed on the valleculae and when the laryngoscope was lifted to achieve the best laryngeal view (both P<0.001).

CONCLUSIONS:

Compared to a standard-sized Macintosh blade, a smaller-sized Macintosh curved blade improved the laryngeal exposure in edentulous patients.

KEYWORDS:

Edentulous patients; Laryngeal view; Macintosh curved blade

PMID:
28974373
DOI:
10.1016/j.ajem.2017.09.050
[Indexed for MEDLINE]

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