The Effect of Lithotomy-Trendelenburg Position and Carbon Dioxide Insufflation on the Distance from the Upper Incisor to the Carina / 대한마취과학회지

ABSTRACT

BACKGROUND: The carbon dioxide (CO2) insufflation and lithotomy-Trendelenburg position are required in the laparoscopic gynecologic surgery. However, they can change the distance from the upper incisor to the carina. This may increase the risk of endobronchial intubation. METHODS: Nineteen patients, aged 29-50 yr, who were undergoing laparoscopic surgery were enrolled. We measured the distance from the upper incisor to the carina of them with fiberoptic bronchoscope. Measurements were taken in the each point of lithotomy position, lithotomy-Trendelenburg position, and lithotomy-Trendelenburg position after CO2 insufflation. RESULTS: The average distance from the upper incisor to the carina was 23.1 +/- 1.4 cm in the lithotomy position (0 degree) and was significantly decreased to 22.6 +/- 1.4 cm in the lithotomy-Trendelenburg position (15 degrees) (P<0.05). After CO2 insufflation into the abdominal cavity, the mean distance in the lithotomy-Trendelenburg position (15 degrees) was significantly decreased to 22.1 +/- 1.4 cm (P<0.05). CONCLUSIONS: The lithotomy-Trendelenburg position and CO2 insufflation decrease the distance from the upper incisor to the carina.