Effect of a new intubation device on the sterno-mental distance in obese patients

Jan Paul J Mulier, M.D., Ph.D., Department of Anaesthesiology AZ st-Jan AV, Brugge, Belgium.

Jan.Mulier@azbrugge.be

  1. Savva D. Prediction of difficult tracheal intubation Br. J. Anaesth., 1994; 73: 149-153

  2. Anesthesiology 2006;105:A873

References

Goal of this study was to measure the sterno mental distance,

before and after inflation of the new intubation device

Background and Goal of Study •  The sterno mental distance determines the difficulty in

intubation. •  Elevation of the upper body by an angulated pillow

facilitates the intubation in obese patients. •  Pillow positioning and removal are difficult in obese

patients. •  Elevation of the shoulders is not needed

•  The new proposed device is a trapezoidal inflatable bag put under the thoracic column and not under the shoulders. •  It lifts and rotates by its trapezoid size only the thoracic

column. •  It can be positioned flat under the patient. • Only at the moment of intubation it is inflated and no

removal is needed during the operation.

Results and Discussions

Inflating the intubation device increases significantly the sterno mandibular length from 12,1 cm to 16,3 cm. significant (p = 0,003). The BMI correlates significantly with the initial sterno mental distance. A short sterno mandibular distance correlates significantly with the length increase when the intubation device is inflated.

.

Comparing deflated (off) with inflated (on) intubation device on SM distance

Conclusion The inflatable intubation device significantly increases

the sterno mandibular distance.

Materials and Methods • 20 patients, ASA I, II and III, 21 - 75 y, bmi > 25 • Approval from the hospital ethical committee. • Intubation device is positioned uninflated under the thoracic spinal column. The head is positioned in the sniffing position with maximum extension. The sterno mental distance is measured in cm as described by Savva D. The intubation device is inflated to its volume of 2,5 liter and the sterno mental distance is measured again. • Following parameters are noted for each patient: age, body weight, length, sex, BMI. • A paired t test on sterno-mental distance with and without intubation device. • Linear regression analysis is used to describe the parameters that correlate significantly with the sterno-mandibular length and length increase.

Anesthesiology 2006; 105: A873 , Annual Meeting ASA October 14-18, 2006 McCormick Place-Chicago, Illinois