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TECHNOLOGY, COMPUTING, AND SIMULATION

A New Curved Laryngoscope Blade for Routine and Difficult Tracheal Intubation

Koji Nishikawa, MD, PhD^*, Koki Yamada, MD, PhD^*, and Atsuhiro Sakamoto, MD, PhD

From the *Department of Anesthesiology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan; and Department of Anesthesiology, Nippon Medical School Hospital, Tokyo, Japan.

Address correspondence and reprint requests to Dr. Koji Nishikawa, Department of Anesthesiology, Nippon Medical School Tama Nagayama Hospital, Nagayama 1-7-1, Tama-shi, Tokyo 206-8512, Japan. Address e-mail to nagayamamasui60{at}yahoo.co.jp.

We have designed a new curved laryngoscope blade based on a new concept of reversing the peardrop phenomenon to facilitate a view of the larynx sufficient for intubation in a greater variety of patients than the current Macintosh blade affords. The new design has a bifid tip and S-shaped spatula to exert more effective pressure in the vallecula area, elevate the epiglottis and change directions of the forces on the tongue to prevent posteroinferior displacement of the compressed tongue in the submandibular space during laryngoscopy. A radiograph laryngoscopy technique was used to guide the new blade curvature design and compare the performance of the new blade with the Macintosh blade in patients with or without a difficult airway. Our results confirm that the new blade provides a laryngeal view sufficient to accomplish intubation by compressing the root of the tongue in an anterocephalad direction in the submandibular space and elevating the epiglottis effectively in patients with or without unanticipated difficult airway. The new curved blade can also effectively move the U-shaped epiglottis out of the laryngeal view to facilitate intubation in pediatric patients aged 2 mo–13 yr.