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44518 - RADIOGRAPHIC EVALUATION OF CERVICAL SPINE MOVEMENT DURING FLEXIBLE VIDEOBRONCHOSCOPY & LO-PRO GLIDESCOPE; A RANDOMISED CONTROLLED TRIAL

¹ University Health Network, Toronto Western Hospital, Toronto, ON, Canada
² Toronto Western Hospital
³ Toronto Western Hospital
⁴ Toronto Western Hospital
⁵ Toronto Western Hospital
⁶ Toronto General Hospital

Abstract

INTRODUCTION: It is essential to prevent or minimize cervical spine movement in patients with c-spine injury. Flexible bronchospcopy (FB) is widely regarded as the gold standard for intubating patients with airway instability. The Lo-Pro Glidescope (LP-G) is a new improved video laryngoscope and may be associated with less c-spine movement. We aimed to compare c-spine movement using fluoroscopy during intubation with FB versus LP-G.

METHODS: After ethics board approval 28 consenting adults with no cervical spine abnormality were randomized to be intubated with either a FB or LP-G. Demographic data was collected. During intubation continuous video fluoroscopy of the cervical spine was performed. A neuroradiologist and a spine surgeon assessed c-spine movement independently. The primary endpoint was maximum angulations during the intubation sequence (Occ-C1, C1-2, C2-4, and C4-5). Power of the study was determined by considering a 1-degree change in angulations as significant. Mann Whitney U test was used to compare maximum range of motion and Wilcoxin signed rank test for interobserver differences.

RESULTS: No significant differences between FB and the LP-G groups in demographic data. Intubation times were comparable between LP-G (31+ 2 sec) and FB (31+ 3secs).

Max. change mean &#61617; SD, *p<0.05, **p<0.01

DISCUSSION: The Lo-Pro Glidescope has significantly greater movement that the Flexible bronchoscopy. This study has shown that there is some movement associated even with the Flexible Bronchoscopy.

REFERENCES:

1 Turkstra TP. Crane RA. Pelz DM. Gelb AW. Anesth Analg. 2005:101:910–5[Abstract/Free Full Text]

2 Cooper RM. Can J Anesth 2003;50:611–3.[Abstract/Free Full Text]