광봉을 이용한 기관내 삽관 시 냄새맡기 자세와 중립 자세의 비교

Abstract

The sniffing position is recommended for optimal glottic visualization under direct laryngoscopy. However, there is no study assessing whether sniffing position is superior to a neutral position during lightwand-guided intubation. This prospective, randomized study was performed to compare facilitation of lightwand-guided intubation between the sniffing and neutral positions. Methods:The study included 180 patients with normal cervical spines requiring tracheal intubation for elective surgery. Patients were randomly allocated into two groups: neutral or sniffing position. Mallampati class, mouth opening distance, thyromental distance, and laryngeal view grade were measured. A lightwand railroaded with an endotracheal tube was bent 90o at 5 cm from the distal end for both groups. Time to intubation, success rate and intubation time for the first attempt, hydrodynamic changes, and BIS values were recorded. Results:There were no significant differences in time to intubation, success rate and intubation time of the first trial, hydrodynamic changes, or BIS values between the two positions. Conclusions:Routine use of the sniffing position does not provide any advantage over the neutral position during lightwand-guided intubation.