Korean J Anesthesiol.  2003 Sep;45(3):310-314. 10.4097/kjae.2003.45.3.310.

The Effectiveness of a Modified Laryngoscope Blade on Reducing the Potential of Dental Trauma

Affiliations
  • 1Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea. jchoi@catholic.ac.kr
  • 2Department of Anesthesiology, School of Medicine, Jung-Ang University, Seoul, Korea.

Abstract

BACKGROUND: Despite progress in intubation techniques, dental trauma is one of the most common complications of general anesthesia. As the flange of the Macintosh blade appears responsible for most dental injuries, we modified the ordinary Macintosh blade by partially removing its flange and evaluated the effectiveness of the modified blade in terms of reducing potential of dental injuries.
METHODS
Four hundred and eighty-three patients scheduled for elective surgery requiring general anesthesia with endotracheal tube placement were included in this prospective study. Laryngoscopy was performed twice, once using an ordinary Macintosh No. 3 blade and once using the modified Macintosh blade. The modification consisted of reducing the height of the flange by partial removal, as described by Callander et al. When optimum visibility of the glottis was obtained, the distance between the flange of the blade and the upper incisor was measured. We compared blade-tooth distances and laryngoscopic views for the two blades.
RESULTS
The modified blade with low-height flange provided more distance than the ordinary type of blade (P<0.01). The incidence of direct contact between the blade and the upper tooth was 20.3% when the ordinary blade was used, and nearly 80% of these did not involve direct contact when using the modified blade. In addition, the modified blade provided a greater field of view than the ordinary blade (P<0.01).
CONCLUSIONS
The modified Macintosh blade used in this study proved to be a useful device, which could reduce dental injuries and provide a better laryngoscopic view during laryngoscopy.

Keyword

dental trauma; endotracheal intubation; laryngoscope blade

MeSH Terms

Anesthesia, General
Glottis
Humans
Incidence
Incisor
Intubation
Intubation, Intratracheal
Laryngoscopes*
Laryngoscopy
Prospective Studies
Tooth
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