title: A comparison of direct laryngoscopy and jaw thrust to aid fibreoptic intubation.
abstract: We compared two manoeuvres, jaw thrust and laryngoscopy, to open the airway during fibreoptic intubation in 50 patients after induction of anaesthesia in a crossover study. Patients were randomly allocated to receive either jaw thrust or conventional Macintosh laryngoscopy first. Airway clearance was assessed at both the soft palate and the epiglottis. Direct laryngoscopy provided significantly better airway clearance at the level of the soft palate than jaw thrust (44 (88%) vs 31 (62%), respectively; p = 0.002). At the level of the larynx, airway clearance was equally good in both groups (45 (90%) vs 46 (92%), respectively; p = 0.56). The times to view the larynx (median (interquartile range [range]) 4 (3-5 [2-35]) s vs 3 (3-4 [2-8]) s, respectively) and intubation time (20 (17-23 [11-83]) s vs 18 (15-20 [11-28]) s, respectively) were also similar.
authors.affiliation: Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Cardiff, CF14 4XW, UK. airwayman@doctors.org.uk <airwayman@doctors.org.uk>
authors.forename: M R
authors.initials: MR
authors.lastname: Stacey
authors.forename: S
authors.initials: S
authors.lastname: Rassam
authors.forename: R
authors.initials: R
authors.lastname: Sivasankar
authors.forename: J E
authors.initials: JE
authors.lastname: Hall
authors.forename: I P
authors.initials: IP
authors.lastname: Latto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000517:prevention & control; D000768:Anesthesia, General; D001794:Blood Pressure; D018592:Cross-Over Studies; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods*; D019416:Head Movements; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007568:Jaw; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged