{"id":117271,"date":"2018-03-11T10:46:42","date_gmt":"2018-03-11T10:46:42","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/evaluacion-del-laringoscopio-macintosh-versus-airtraq-en-la-poblacion-obesa-morbida\/"},"modified":"2018-03-11T10:46:42","modified_gmt":"2018-03-11T10:46:42","slug":"evaluacion-del-laringoscopio-macintosh-versus-airtraq-en-la-poblacion-obesa-morbida","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/anatomia-humana\/evaluacion-del-laringoscopio-macintosh-versus-airtraq-en-la-poblacion-obesa-morbida\/","title":{"rendered":"Evaluaci\u00f3n del laringoscopio macintosh versus airtraq en la poblaci\u00f3n obesa m\u00f3rbida"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Caridad Greta Castillo Monzon <\/strong><\/h2>\n<p>Introducci\u00f3n la obesidad m\u00f3rbida se asocia con manejo dif\u00edcil de la v\u00eda a\u00e9rea. No existiendo com\u00fan acuerdo en que estos pacientes sean dif\u00edciles de intubar pero si existe en que son dif\u00edciles de ventilar con m\u00e1scara facial, por lo que es prioritario el control r\u00e1pido de su v\u00eda a\u00e9rea. Ello ha motivado la b\u00fasqueda de factores predictores y t\u00e9cnicas para tratar de disminuir los riesgos en esta poblaci\u00f3n. El laringoscopio \u00f3ptico airtraq\u00c2\u00bf, es un dispositivo descartable con hoja anat\u00f3mica que permite una intubaci\u00f3n sin alineaci\u00f3n de los ejes oro-faringo-lar\u00edngeo, un mayor campo de visi\u00f3n, curva de aprendizaje corta, y no requiere aplicaci\u00f3n de fuerza para exponer la glotis. Esta tesis se plante\u00f3 para evaluar si el laringoscopio \u00f3ptico airtraq\u00c2\u00bf permite un manejo m\u00e1s r\u00e1pido de la v\u00eda a\u00e9rea que el laringoscopio de macintosh en el paciente obeso m\u00f3rbido. Se compara con el laringoscopio macintosh por ser este el laringoscopio est\u00e1ndar para el manejo de la v\u00eda a\u00e9rea. objetivos comparar la rapidez de la intubaci\u00f3n traqueal del laringoscopio de macintosh versus el laringoscopio \u00f3ptico airtraq\u00c2\u00bf y el \u00e9xito de la misma en la poblaci\u00f3n obesa m\u00f3rbida en cirug\u00eda programada. Comparar la visi\u00f3n de la glotis con ambos laringoscopios. Comparar la respuesta hemodin\u00e1mica al uso de ambos dispositivos y las complicaciones derivadas de su empleo. material y m\u00e9todos estudio prospectivo, observacional, longitudinal y anal\u00edtico, realizado en el hospital general universitario santa luc\u00eda, de cartagena, murcia. Se incluyeron 46 pacientes obesos m\u00f3rbidos, mayores de 18 a\u00f1os, asa iii, programados para cirug\u00eda electiva, que fueron asignados en forma aleatorizada para ser intubados con el laringoscopio macintosh (n=23) o el dispositivo \u00f3ptico airtraq\u00c2\u00bf (n=23), manejados con la misma t\u00e9cnica anest\u00e9sica e intubados por la investigadora. Se compar\u00f3: el tiempo de intubaci\u00f3n, la visi\u00f3n lar\u00edngea, la necesidad de maniobras adicionales para realizar la intubaci\u00f3n traqueal, el \u00e9xito de la maniobra, las complicaciones y la respuesta hemodin\u00e1mica. resultados las caracter\u00edsticas preoperatorias de los pacientes estudiados fueron similares en ambos grupos. El tiempo promedio de la intubaci\u00f3n fue 17,27 \u00c2\u00b116,1 seg y 22,11 \u00c2\u00b1 13,62 seg en los grupos airtraq\u00c2\u00bf y macintosh respectivamente (p 0,279). Con el dispositivo airtraq\u00c2\u00bf el 95,65% de pacientes presentaron una visi\u00f3n gl\u00f3tica 1 y 2a (p=0,006) y fueron necesarias menos maniobras de optimizaci\u00f3n para realizar la intubaci\u00f3n traqueal (p=0,001). No se presentaron casos de intubaci\u00f3n dif\u00edcil, fallida ni ventilaci\u00f3n dif\u00edcil. Se detect\u00f3 un aumento de la frecuencia cardiaca estad\u00edsticamente significativo con el empleo del laringoscopio macintosh. Un paciente con epiglotis redundante no pudo ser intubado con el laringoscopio \u00f3ptico airtraq\u00c2\u00bf. conclusiones en este estudio, ambos dispositivos permitieron un manejo r\u00e1pido y seguro de la v\u00eda a\u00e9rea. El empleo del laringoscopio airtraq\u00c2\u00bf permite una mejor visi\u00f3n gl\u00f3tica y ello reduce las maniobras adicionales para realizar la intubaci\u00f3n traqueal y se detecta un menor est\u00edmulo simp\u00e1tico evidenciado por un menor aumento de la frecuencia cardiaca posterior a la intubaci\u00f3n traqueal. La epiglotis redundante se muestra como un posible factor limitante para el \u00e9xito de la intubaci\u00f3n con el laringoscopio \u00f3ptico airtraq\u00c2\u00bf. palabras clave: v\u00eda a\u00e9rea dif\u00edcil, obesidad m\u00f3rbida, intubaci\u00f3n traqueal, equipamiento, laringoscopio, airtraq\u00c2\u00bf. t\u00e9rminos tesauro: [241002] anatom\u00eda humana. [241102] anestesiolog\u00eda. [321303] anestesiolog\u00eda quir\u00fargica.   summary  introduction morbid obesity is associated with difficult handling of the airway. No agreement exists that these patients are difficult to intubate but if they are difficult to ventilate with facial mask, so it is a priority the fast control of their airway. This has motivated the search of predictors and handling techniques to try to reduce the risks in this population. The airtraq\u00c2\u00bf optic laryngoscope is a disposable device with anatomic blade that permits an intubation without alienation of the oral, pharyngeal and laryngeal axes, a larger field of vision, a short learning curve and it does not requires application of force to expose the glottis. This thesis was set to evaluate if the airtraq\u00c2\u00bf optic laryngoscope allows a faster handling of the air track that the macintosh laryngoscope in the morbid obesity patient. It compares to the macintosh laryngoscope for being this the standard laryngoscope for the airway handling. objectives compare the quickness of the tracheal intubation of the macintosh laryngoscope versus the airtraq\u00c2\u00bf optic laryngoscope and the success of both in the morbid obesity population in programmed surgery. Compare the vision of the glottis with both laryngoscopes. Compare the hemodynamic answer in the use of both devices and the complications derived from its use. materials and methods prospective, observational, longitudinal and analytic study, realized in the santa lucia universitary general hospital, from cartagena, murcia. It included 46 morbid obesity patients, older than 18 years, asa iii, programmed for elective surgery, that were assigned in random patterns for being intubated with the macintosh laryngoscope (n=23) or the airtraq\u00c2\u00bf optical device (n=23), operated with the same anaesthetic technique and intubated for the researcher. It was compared: the time of the intubation, the laryngeal vision, the necessity of additional manoeuvres to realize the tracheal intubation, the success of the manoeuvres, the complications and the hemodynamic answer.  results the pre-operatory characteristics of the studied patients were similar in both groups. The average time of the intubation was 17,27 \u00c2\u00b1 16,1 seg and 22,11 \u00c2\u00b1 13,62 seg in the airtraq\u00c2\u00bf and macintosh groups respectively (p 0,279). With the airtraq\u00c2\u00bf device the 95,65% of patients presented a glottic view 1 and 2a (p=0,006) and less optimizing manoeuvres were needed to realize the tracheal intubation (p=0,001). There were not presented any difficult intubation, failed intubation, or difficult ventilation cases. It was detected a raise in the cardiac frequency statistically significant with the use of the macintosh laryngoscope. A patient with redundant epiglottis couldn&apos;t be intubated with the airtraq\u00c2\u00bf optic laryngoscope.  conclusions in this study, both devices permitted a quick handling and security of the airway. The use of the airtraq\u00c2\u00bf laryngoscope permits a better glottic view and that reduces the additional manoeuvres to realize the tracheal intubation and detects a minor adrenergic stimulus proved by a minor rise in the posterior cardiac frequency to the tracheal intubation. The redundant epiglottis it is shown as a possible limiting factor for the success of the intubation with the airtraq\u00c2\u00bf optic laryngoscope.   key words: difficult airway, morbid obesity, tracheal intubation, equipment, laryngoscope, airtraq\u00c2\u00bf.  thesaurus terms: [241002] human anatomy. [241102] anaesthesiology. [321303] surgical anaesthesia.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Evaluaci\u00f3n del laringoscopio macintosh versus airtraq en la poblaci\u00f3n obesa m\u00f3rbida<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Evaluaci\u00f3n del laringoscopio macintosh versus airtraq en la poblaci\u00f3n obesa m\u00f3rbida <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Caridad Greta Castillo Monzon <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 13\/03\/2015<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Blas Garcia Rojo<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: fernando Gilsanz rodr\u00edguez <\/li>\n<li>Jos\u00e9 Antonio Alvarez gomez (vocal)<\/li>\n<li>Mar\u00eda  dolores Carceles baron (vocal)<\/li>\n<li>Jos\u00e9 Luis Vazquez rojas (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Caridad Greta Castillo Monzon Introducci\u00f3n la obesidad m\u00f3rbida se asocia con manejo dif\u00edcil de la v\u00eda a\u00e9rea. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[867,13400,1569,8235],"tags":[175403,231154,30129,138974,90984,45666],"class_list":["post-117271","post","type-post","status-publish","format-standard","hentry","category-anatomia-humana","category-anestesiologia","category-anestesiologia-quirurgica","category-murcia","tag-blas-garcia-rojo","tag-caridad-greta-castillo-monzon","tag-fernando-gilsanz-rodriguez","tag-jose-antonio-alvarez-gomez","tag-jose-luis-vazquez-rojas","tag-maria-dolores-carceles-baron"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117271","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=117271"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117271\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=117271"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=117271"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=117271"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}