Effect of manual in-line stabilization of the cervical spine in adults on the rate of difficult orotracheal intubation by direct laryngoscopy: a randomized controlled trial

Purpose Although manual in-line stabilization (MILS) is commonly used during endotracheal intubation in patients with either known or suspected cervical spine instability, the effect of MILS on orotracheal intubation is poorly documented. This study evaluated the rate of failed tracheal intubation i...

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Veröffentlicht in:Canadian journal of anesthesia 2009-06, Vol.56 (6), p.412-418
Hauptverfasser: Thiboutot, François, Nicole, Pierre C., Trépanier, Claude A., Turgeon, Alexis F., Lessard, Martin R.
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Sprache:eng
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Zusammenfassung:Purpose Although manual in-line stabilization (MILS) is commonly used during endotracheal intubation in patients with either known or suspected cervical spine instability, the effect of MILS on orotracheal intubation is poorly documented. This study evaluated the rate of failed tracheal intubation in a fixed time interval with MILS. Methods Two hundred elective surgical patients were randomized into two groups. In the MILS group, the patient’s head was stabilized in a neutral position by grasping the patient’s mastoid processes to minimize any head movement during tracheal intubation. In the control group, the patient’s head rested in an optimal position for tracheal intubation. A 30-sec period was allowed to complete tracheal intubation with a #3 Macintosh laryngoscope blade. The primary endpoint was the rate of failed tracheal intubation at 30 sec. Secondary endpoints included tracheal intubation time and the Cormack & Lehane grade of laryngoscopy. Results Patient characteristics were similar with respect to demographic data and risk factors for difficult tracheal intubation. The rate of failed tracheal intubation at 30 sec was 50% (47/94) in the MILS group compared to 5.7% (6/105) in the control group ( P  
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-009-9089-7