Cricoid pressure with the Truview Evo2™ laryngoscope improves the glottic view

Nishant Kumar, Debadutta Behera, Jaspal Singh Dali, Mona Arya, Amita Gupta
Canadian Journal of Anaesthesia 2011, 58 (9): 810-4

OBJECTIVE: The Truview Evo2™ laryngoscope blade is designed to improve glottic view. This study was designed to evaluate the effect of cricoid pressure (CP) on laryngeal view and the ease of orotracheal intubation with the Truview Evo2 laryngoscope.

METHODS: In this randomized controlled trial, 50 patients (American Society of Anesthesiologists physical status I-II, aged 18 to 60 yr) scheduled for elective surgery were enrolled. After induction of anesthesia and muscle paralysis, laryngoscopy was performed using the Truview Evo2™ laryngoscope with the patient's head in the neutral position. In Group 1, the percentage of glottic opening (POGO) score was evaluated first without CP, then with CP, and CP was applied for intubation. In Group 2, the POGO score was evaluated first with CP, then without CP, and no CP was applied for intubation. Time to intubation and number of attempts required for intubation were also recorded.

RESULTS: In 50 patients, the mean (standard deviation) POGO view obtained with the application of CP was 93% (10%) compared with 81% (19%) in patients without CP (P < 0.01). Times to intubation were similar in the two groups: 14.2 (6.6) sec vs 14.0 (9.3) sec in Groups 1 and 2, respectively (P = 0.924). Sixteen percent of patients in Group 1 required a second attempt at tracheal intubation, while only 4% of patients in Group 2 required a second attempt (P = 0.162).

CONCLUSION: When using the Truview Evo2™ laryngoscope with the patient's head in the neutral position, application of CP improves the glottic view. This approach is not associated with increased difficulty in intubation.

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