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Transverse forces exerted on the maxillary incisors during laryngoscopy
M J Bucx1, M H van der Vegt, C J Snijders
1Department of Anaesthesia, University of Amsterdam, The Netherlands.
Summary
Intubation experience significantly reduces harmful transverse forces on maxillary incisors. More experienced intubators apply less force, protecting dental structures during laryngoscopy.
Area of Science:
- Anesthesiology
- Medical Devices
- Dental Trauma
Background:
- Laryngoscopy is a critical step in airway management.
- The Macintosh laryngoscope is commonly used for intubation.
- Potential for dental injury exists during laryngoscopy.
Purpose of the Study:
- To investigate the impact of intubator experience on forces exerted by the Macintosh laryngoscope.
- To analyze forces in both axial and transverse directions on maxillary incisors.
- To determine if experience influences the magnitude and direction of applied forces.
Main Methods:
- Five experience groups (staff anesthetists, residents, nurse anesthetists, surgeons, students) were studied.
- Each participant performed laryngoscopy and intubation on a manikin.
- Sensors measured axial and transverse forces applied to the maxillary incisors.
Main Results:
- Significant correlation found between experience level and maximal transverse forces (Fmtpmax).
- Experienced intubators (anesthetists, residents) applied significantly less transverse force (Fmtnmax) toward the intubator.
- While some high forces were recorded, experienced practitioners generally exerted lower transverse forces.
Conclusions:
- Intubator experience has a beneficial effect on reducing transverse forces during laryngoscopy.
- This suggests experience can mitigate the risk of dental injury from laryngoscope use.
- Axial forces were not significantly affected by experience in this study.