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BIBTEX RIS

Tracheal intubation in an adult male with Mallampati class zero airway

2005; Springer Science+Business Media; Volume: 52; Issue: 1 Linguagem: Inglês

10.1007/bf03018596

ISSN

1496-8975

Autores

Tadakazu Sakuragi, Koichiro Hori, Takahisa Shiratake, Junko Miyawaki, Miki Ishida,

Tópico(s)

Foreign Body Medical Cases

Resumo

using hospital weighing scales (Autoweigh Scales UK PLC, Weigh House, West Yorkshire, UK) by the technique of Clayton and Vanner, 3 PEFR using an 'Airmed' Medical Research Council designed meter and a standard technique. 4Discomfort was graded as 'any' or 'none'.Statistical analysis used paired t tests, Chisquared test, Pearson correlation, McNemar's test, and Wilcoxon signed-rank sum test, and ANOVA.P < 0.05 was taken as significance.Of 30 volunteers, 16 (53%) were male.Mean (standard deviation [range]) age was 35 (9 [20-55]) yr and weight was 77 (17 [52-126]) kg.Discomfort occurred in 12 patients (40%) at forces ranging from 15N to 40N (Figure) but there were no statistically significant relationships between age, weight and sex of the subjects and the occurrence of discomfort.Mean (standard deviation) PEFR fell in all subjects from 506 (116) L•min -1 before cricoid pressure to 451 (136) L•min -1 (95% confidence interval [CI] for difference 34-75 L•min -1 ; P = 0.0001), with a fall from 397 (51) L•min -1 to 344 (64) L•min -1 (95% CI for difference 11-94 L•min -1 ; P = 0.014) in those subjects who experienced discomfort.Twenty-nine subjects tolerated forces within the range currently considered effective. 3None found the performance of PEFRs difficult during cricoid pressure.A simple means of estimating cricoid force would be useful in preventing the corollaries of inadequate or excessive forces.Discomfort does not seem to do so, since forces within recommended maxima can cause discomfort and reduction of PEFR.However, our results do support previous work showing reduction of tidal volumes and cricoid compression with cricoid pressure, 1,2 and suggest that discomfort indicates when airway obstruction has occurred.

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