Degree of cervical mobility differs or not when using alternative way of intubation: Intubating laryngeal mask or classic laryngoscope

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

igure 1 Lateral cervical spine demonstrating a & b angles [2].

able 1 El Ganzouri scoring system [1].

Assessment	0	1	2
BW	<90 kg	90–110 kg	>110 kg
Previous history of difficult intubation	None	Questionable	Definite
Mouth opening	>4 cm	<4 cm	Can’t open
Mallampati	Class I	Class II	Class III
Buck teeth	Can prognathism or edentulous	Can approximate teeth only	Can’t approximate teeth
Thyromental distance	>6.5 cm	6–6.5 cm	<6 cm
Head/neck movement	>90°	=90°	<90°
AW score	0	7	14

able 2 The mean age, weight and height for the both groups.

Group		Age	Wt	Ht
(1) ILMA	Mean	38.95	80.50	166.00
	Std. deviation	11.555	8.256	5.282
(2) Direct	Mean	41.00	79.75	166.25
	Std. deviation	11.530	9.244	4.833
	p value	0.578	0.788	0.877

igure 2 AWS for all patients.

igure 3 Flow chart for AWS. AWS: airway score.

able 3 The mean systolic BPs, mean diastolic BPs, mean heart rate (pre-insertion and post-insertion).

	Group 1	Group 2	p value
Preinsertion (mean systolic pressure)	121.5 ± 14.2 mmHg	119.5 ± 13.2 mmHg	0.647
Postinsertion (mean systolic pressure)	136 ± 11.9 mmHg	137.5 ± 13.3 mmHg	0.709
Preinsertion (mean diastolic pressure)	75.5 ± 11.5 mmHg	74.5 ± 11 mmHg	0.780
Postinsertion (mean diastolic pressure)	85 ± 7.6 mmHg	86 ± 6 mmHg	0.647
Preinsertion (heart rate)	73.9 ± 6.4 mmHg	73.7 ± 6.3 mmHg	0.902
Postinsertion (heart rate)	84.05 ± 8.4 mmHg	89.9 ± 6.5 mmHg	0.018

igure 4 Mean SPO2 among the two groups (p-value 0.194).

igure 5 Flow chart for cervical spine extension at C1/C2.

able 4 Mean cervical spine extension at C1/C2 & C2/C3 before, during and after intubation in both groups.

Mean cervical spine extension	Before intubation	During intubation	After intubation
C1/C2 group 1	77.2 ± 3.5	74.8 ± 4.3	75.9 ± 4.2
C1/C2 group 2	74.95 ± 4	65.9 ± 4.4	68.75 ± 3.9
p value	0.066	0.000	0.000
C2/C3 group 1	100 ± 3.3	102.2 ± 3.6	102.2 ± 3.6
C2/C3 group 2	99.85 ± 3.6	106.75 ± 4	103.1 ± 4.8
p value	0.89	0.001	0.506

able 5 Mean time for device insertion.

ILMA	Mean	55.80 s
	Std. deviation	7.537 s
Direct	Mean	21.90 s
	Std. deviation	4.712 s

p value 0.605.

able 6 Mucosal injury during device and tube insertion.

			Group
			ILMA	Direct
Mucosal injury	No	Count	17	19
		% within Group	85.0%	95.0%
	Yes	Count	3	1
		% within Group	15.0%	5.0%
Total	Count		20	20
	% within Group		100.0%	100.0%