[The early axial traction of the cervical spine after anaesthesia with intubation and extreme reclination of the head].
OBJECTIVE
Patients who have an operation under general anaesthesia with muscle relaxation often complain about neck pain if the head needs to be placed in extreme reclination to facilitate surgical access. Patients complain about vertigo, light muscle tenseness but also about severe joint blockages in the neck region. Due to this complication the standard practise in some hospitals is to refer these patients routinely to a physiotherapist postoperatively. This study investigated the influence of an axial traction - a treatment which can easily be learned by anaesthesiologists - on blockages of the cervical spine in those patients.


METHODS
In two randomised groups (n = 15 each) of preoperative inconspicuous patients the following directions of motion were investigated: Ante- and retroflexion of C0/1, side inclination C0/1, side nodding and side movement C2/3 to C6/T1, dorsal movement C5/Th2. The examinations took place at the preoperative anaesthetic round, shortly before extubation, two hours after extubation and the next day. Additionally the patients were asked about their discomfort. An axial traction of the cervical spine was performed in one group after extubation. The number of new blockages and the subjective discomfort of the patients was compared with the Chi-Square test.


RESULTS
An axial traction of the cervical spine reduces the frequency and the intensity of symptoms significantly.


CONCLUSIONS
It was investigated whether an axial traction of the cervical spine - a treatment that can easily be learned by anaesthesiologists - could improve patients' comfort. The study showed that an axial traction of the cervical spine immediately after extubation reduces the frequency and intensity of symptoms significantly. This treatment is highly effective, not very time consuming and, if done correctly, without any risk for the patient. By using this treatment routinely, additional expenses for physiotherapeutic interventions could be reduced.
Goldmann
R
R
Zentrum Anästhesiologie, Abteilung Anästhesiologie I, Medizinische Hochschule Hannover. Rolf.Goldmann@gmx.de
Bornscheuer
A
A
Schultze-Florey
T
T
Kriebel-Goldmann
C
C
Höltje
M
M
D000328:Adult; D000769:Anesthesia, Inhalation; D001268:Atlanto-Axial Joint; D002574:Cervical Vertebrae / Q000502:physiology*; D005260:Female; D006257:Head / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D011183:Postoperative Complications / Q000517:prevention & control*; D011187:Posture / Q000502:physiology*; D014143:Traction