The effect of placement of a support under the shoulders on laryngeal visualization with a C-MAC Miller Video Laryngoscope in children younger than 2 years of age


Gencay Z. K. , BEGEÇ Z. , ÖZGÜL Ü. , ÇOLAK C.

PEDIATRIC ANESTHESIA, vol.29, no.8, pp.814-820, 2019 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 8
  • Publication Date: 2019
  • Doi Number: 10.1111/pan.13685
  • Title of Journal : PEDIATRIC ANESTHESIA
  • Page Numbers: pp.814-820

Abstract

Background We aimed to evaluate glottis visualization and time to intubation in children younger than 2 years of age during laryngoscopy performed with a C-MAC Miller Video Laryngoscope in a position determined by placing a folded towel under the shoulders to align the oral-pharyngeal and laryngeal axes in the horizontal plane. Methods Ninety-six children younger than 2 years of age, who were classified by the American Society of Anesthesiologists as having a physical status I or II and who were scheduled for elective surgery necessitating endotracheal intubation under general anesthesia, were included in the study. All patients were intubated with a C-MAC Miller Video Laryngoscope. The children intubated by placing a folded towel under the shoulders were categorized as Group 1 (n = 48), and the children intubated without placement of a folded towel were categorized as Group 2 (n = 48). The percentage of glottis opening and Cormack-Lehane Scores, values of visual analogue scale to determine the ease of using a C-MAC Miller Video Laryngoscope, time to intubation, number of intubation attempts, optimization procedures and complications were recorded for all children. Results There was a statistically significant difference between Group 1 (mean +/- SD; 97.71 +/- 4.24) and Group 2 (mean +/- SD; 94.17 +/- 7.09) in terms of the percentage of glottis opening scores (P = 0.004). The mean difference in the percentage of glottis opening scores (95% confidence interval) between the groups was 3.54 (1.17-5.90). Conclusion We showed that a folded towel placed under the shoulders in children younger than 2 years of age improves glottis visualization provides ease of use of the C-MAC Miller Video Laryngoscope. Therefore, we think that the placement of a folded towel under the shoulders during the use of a C-MAC Miller Video Laryngoscope may be useful for airway management in children younger than 2 years of age.