Inadequate spinal block.
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Biomedical subjects
Publications and source records attributed to C A Render.
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This study was undertaken to evaluate the effect of the levering laryngoscope on the view obtained at laryngoscopy. Two hundred and ten consecutive patients who required tracheal intubation were studied. The view at laryngoscopy with the levering laryngoscope blade in the neutral and elevated positions was recorded. In patients in whom there was a Cormack and Lehane grade 3 view of the larynx with the blade in the neutral position, elevation of the levered tip of the blade significantly improved the visualisation of the larynx. In patients where the view of the larynx was grade 1 or 2 with the blade in the neutral position, elevation of the levered tip often (23%) resulted in the view being impaired. This was not a clinical problem as the blade could simply be returned to the neutral position. The levering laryngoscope is a useful additional aid to laryngeal visualisation.
The postero-anterior lumbar spine X rays of 163 patients undergoing investigation for back pain were reviewed and the spinal level marking the intersection of a line joining the iliac crests was determined. This point coincided with the L4 spinous process or the L4-5 interspace in 78.6% of patients but was as high as the L3-4 interspace in 3.7% of cases. Reliance on this landmark might lead to more cranial placement of epidural or spinal needles than was intended and this may increase the risk of spinal cord damage.