Is the Laryngeal Lift a Useful Maneuver Improving the Laryngoscopic View for Endotracheal Intubation?

Lee, Sang Kyi

Abstract

BACKGROUND: The larynx is longitudinally stretched and anteriorly displaced by inducing the general anesthesia and muscle paralysis, thus the laryngoscopic visualization might become difficult during direct laryngoscopy. The study was designed to assess the efficacy of the "laryngeal lift" maneuver in improving the laryngoscopic visualization to facilitate tracheal intubation.
METHODS
Following the induction of general anesthesia and muscle paralysis, the laryngoscopic views of 287 patients were evaluated while the laryngeal lift by which the cricoid cartilage was displaced 0.5 cm posteriorly and 1.0~1.5 cm cephaladly were performed. One hundred and three patients with grade 2-4 laryngoscopic veiw were analysed. The laryngoscopic view which was described by Cormack and Lehane was classified from grade 1 to grade 4. The postoperative complications such as dysphasia and/or dyspnea were also observed.
RESULTS
Seventy four patients of 81 patients with the laryngoscopic view of grade 2 were improved by one grade. Twenty one patients of 22 patients with the laryngoscopic view of grade 3 were improved by more than one grade. However, the laryngoscopic views of eight patients out of 103 patients were not improved. The tracheal intubation was successful in all patients. The overall, grade 2 and grade 3 improvement rate of laryngoscopic view was 92.2%, 91.4% and 95.5% respectively. The improvement rate by one grade and two grade was 89.3% and 2.9% respectively.
CONCLUSIONS
The laryngeal lift had the high improvement rates of laryngoscopic view without any complications. Thus it is concluded that the laryngeal lift is a useful maneuver for improving laryngoscopic view during direct laryngoscopy with curved blade of laryngoscope.