Comparative Analysis of Different Techniques of Airway Management in View of Hemodynamic Stability and Postoperative Complication in Patients Undergoing Atlantoaxial Joint Dislocation Surgery

Academia Anesthesiologica International

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Title Comparative Analysis of Different Techniques of Airway Management in View of Hemodynamic Stability and Postoperative Complication in Patients Undergoing Atlantoaxial Joint Dislocation Surgery
 
Creator Samiksha Parashar
Prateek Bais
Abhinav Agarwal
Deepak Malviya
Manoj Giri
Rai, Sujeet
 
Subject Airway
Atlantoaxial Joint
Shoulder Dislocation
 
Description Background: An ideal technique of intubation of the trachea in patients of atlantoaxial joint dislocation surgery remains unclear. This study was undertaken with the primary objective to compare the three different techniques of airway management, in view of hemodynamic stability in patients undergoing atlantoaxial joint dislocation surgery. The secondary objective was to assess the association of postoperative airway complications and the technique of intubation. Subjects and Methods: Adult patiënts aged >18years, American Society of Anaesthesiologists grade I-III, undergoing elective atlantoaxial joint dislocation surgery requiring tracheal intubation were included in the study. Patients with anticipated difficult airway, previous history of cervical spine injury or surgery were excluded from the study. Patients were divided into 3groups, Group1: conventional laryngoscopy, Group 2: video laryngoscopy, Group 3: fiberoptic intubation. Hemodynamic and postoperative neurological status was assessed. Results: 90 patients were studied. The mean age of patients of Group 1, Group 2 and Group 3 was 45.23  10.29,46.8 6.8 and 44.73 9.97 years respectively. At baseline MAP, HR and SpO2 were comparable in all three groups with insignificant intergroup difference (P>0.05). After securing the airway, significant increase in MAP(P= 0.016), HR (p=0.001) was seen on comparing the three groups. No significant association was seen between postoperative airway complications and the intubation technique. Among the 90 patients included, 24(26.67%) patients developed postoperative neurological deficit (quadriparesis, n=18 and upper limb paresis, n=6). 15(16.67%) patients required postoperative mechanical ventilation. 8(53.33%) out of 15 were tracheostomized. No correlation was observed between time duration of securing the airway and postoperative neurological deficit (P=0.7224).  Conclusion:  No corrélation was observed between the technique   or duration of intubation and neurological deterioration in patients undergoing AAD surgery. Conventional laryngoscopy is associated with maximum hemodynamic perturbations and number of reattempts.
 
Publisher Society for Health Care & Research Development
 
Date 2021-06-05
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
application/xml
text/html
application/epub+zip
 
Identifier https://aijournals.com/index.php/aan/article/view/1957
 
Source Academia Anesthesiologica International; Vol 6 No 1 (2021): January-June 2021; 111- 117
2456-7388
2617-5479
 
Language eng
 
Relation https://aijournals.com/index.php/aan/article/view/1957/2308
https://aijournals.com/index.php/aan/article/view/1957/2309
https://aijournals.com/index.php/aan/article/view/1957/2310
https://aijournals.com/index.php/aan/article/view/1957/2311
 
Rights Copyright (c) 2021 Author
https://creativecommons.org/licenses/by/4.0/
 

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