title: A comparison of two techniques for inserting the Airtraq laryngoscope in morbidly obese patients.
abstract: 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 degrees 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.
authors.affiliation: Anaesthesia Department, Jean Verdier Public University Hospital of Paris (APHP), 93143, Bondy- Paris 13 School of Medicine, 93000, Bobigny, France. gilles.dhonneur@jvr.aphp.fr
authors.forename: G
authors.initials: G
authors.lastname: Dhonneur
authors.forename: S K
authors.initials: SK
authors.lastname: Ndoko
authors.forename: R
authors.initials: R
authors.lastname: Amathieu
authors.forename: A
authors.initials: A
authors.lastname: Attias
authors.forename: L E L
authors.initials: LE
authors.lastname: Housseini
authors.forename: C
authors.initials: C
authors.lastname: Polliand
authors.forename: L
authors.initials: L
authors.lastname: Tual
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D009767:Obesity, Morbid / Q000628:therapy*; D009960:Oropharynx / Q000293:injuries; D011446:Prospective Studies; D014741:Video Recording