Is it a matter of habit?

摘要

Theleading cause of anesthesia-related injury is theinability tointubate the trachea and secure the airway. 1Improvements invideo and optical laryngoscopy haveallowed to obtainan indirect view of the glottis in amore simple way butsometimes this advantage occurstogether with a difficultor impossible endotracheal tube(ETT) insertion. 2 This is because indirect techniques do notrequire the alignment of the oral, pharyngeal, and trachealaxes. In this sense the optical laryngoscope Airtraq ? (ProdolMeditecS.A., Vizcaya, Spain) provides an improved indirectview of the upper airway. However, successful intubationrequires optimal positioning of the glottis in the middle oftheviewfinder. There are maneuvers of optimization whenthe glottis is off-center. They can be classified into twogroups. 3---5 (1) Adjustment of the distal position of deviceinvolvingexternal laryngeal manipulation or withdrawal theAirtraqlaryngoscope, and (2) adjustment of the distal posi-tion or the output of the ETT respect the Airtraq usingaintubating stylet, the Endoflex ETT (Merlyn Associates,Tustin,CA, USA) or a flexible fiberoptic bronchoscope. How-ever, occasionally, these maneuvers are not sufficient.