Canadian Journal of Anaesthesia

, Volume 40, Issue 3, pp 279–282 | Cite as

Difficult laryngoscopy made easy with a “BURP”

  • Richard L. Knill
Anaesthetic Techniques

Abstract

Displacement of the larynx by backward, upward and rightward pressure on the thyroid cartilage or “BURP” may improve visualization of the glottis in some cases of difficult direct laryngoscopy. In a patient with the Treacher-Collins syndrome in whom conventional laryngoscopy had proved impossible and tracheal intubation extremely difficult, this manoeuvre exposed the entire glottis and made tracheal intubation under direct vision easy. In a patient with protruding upper incisors and a prominent premaxilla which precluded a view of the glottis by conventional laryngoscopy, “BURP” again revealed the glottic opening and simplified the placement of an endotracheal tube. This experience suggests that “BURP” be considered as a potential aid in the management of difficult direct laryngoscopy.

Key words

Complications: intubation, tracheal Intubation, Tracheal: technique Syndromes: Treacher-Collins 

Résumé

La mobilisation du larynx vers l’arrière, le haut et la droite par manipulation du cartilage thyroïde peut améliorer la visualisation de la glotte lors d’une laryngoscopie directe difficile. Chez un porteur du syndrome de Treacher-Collins sur lequel la laryngoscopie traditionnelle s’était avérée impossible et l’intubation extrêmement difficile, cette manoeuvre a permis une exposition de la glotte en entier et grandement facilité l’intubation sous vision directe. La même observation s’applique à un patient dont une protusion des incisives supérieures et un maxillaire proéminent présentaient un obstacle sérieux à l’intubation. Ces expériences suggèrent que la manoeuvre déjà décrite peut être utile dans les cas d’intubation difficile sous vision directe.

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Copyright information

© Canadian Anesthesiologists 1993

Authors and Affiliations

  • Richard L. Knill
    • 1
  1. 1.Department of Anaesthesia, University HospitalUniversity of Western OntarioLondonCanada

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