Robert Arden Miller (1906 – 1976) American anesthesiologist.
Designed the Miller laryngoscope blade, first manufactured by the Welch-Allyn Company in 1941
When Miller created his blade, most specialist anaesthetists were familiar with the advantages of endotracheal intubation, especially since the widespread use of closed-circuit cyclopropane anaesthesia. Miller’s contribution was to make changes to pre-existing blades to make endotracheal intubation more certain. Miller recommended the use of a stylet rather than forceps when inserting larger, cuffed tubes using a Miller blade, as the mouth did not open as widely.
- Born 1906 Pennsylvania, Williamsport
- 1929 – MD, Eclectic Medical Institute in Cincinnati, Ohio
- 1930-1936 – General practitioner in Detroit
- 1936 – Member of International College of Anesthetists
- 1941 – Member American board of Anesthesia
- 1940-1942 World War II – Captain in the US Army
- Died September 30 1976 San Antonio, Texas
Miller laryngoscope blade (1941)
The Miller laryngoscope is a narrow-lumen, D-shaped, straight-blade designed to obtain a view of the vocal cords by directly lifting the epiglottis. It has useful application in ‘floppy’ airways making it popular within paediatric anaesthesia.
Miller found traditional straight blades to be too thick at the base and too short increasing the risk of trauma to the teeth. Miller modifed the laryngoscopes popular at the time to make tracheal intubation “easier and more certain”. The Miller laryngoscope has a straight blade with a long, curved tip, providing better exposure of the larynx. This made difficult intubations easier to perform and minimised dental trauma.
Miller designed his blade by making it straight and longer than the old style medium blade, rounded at the bottom and smaller at the tip with an extra curve two inches from the end. This made difficult intubations easier to perform and minimised dental trauma. He found this suitable for all patients; except children.
In 1946, Miller developed a blade for use in children. He recommended that tracheal intubation under direct visualization was preferable to the common practice of blind passage facilitated by digital palpation of the epiglottis
- Miller RA. A new laryngoscope. Anesthesiology 1941; 2: 317-320.
- Miller RA. A new laryngoscope for intubation of infants. Anesthesiology. 1946; 7: 205.
- Miller RA. The development of the laryngoscope. Anaesthesist. 1972; 21(3): 145-147.
- Miller RA. The development of the laryngoscope. Middle East J Anaesthesiol. 1974; 4(1): 49-52.
Miller was in private anaesthesia practice in Texas from 1936. According to his American Society of Anesthesiologists biographical file, he made 52 speeches for the Texas society on socialized medicine; whether for or against is not stated.
- Maltby R. Notable Names in Anaesthesia. The Choir Press; pp 141-143 (2013)
- Bateman BT, Alston TA. Commonly used eponyms in anesthesia. J Clin Anesth. 2009; 21(1): 67-71
- Giuca MS, Desai SP. Eponyms in the operating room: careers of five American physicians. Bull Anesth Hist. 2013; 31(2): 32-5, 39.
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