Lee Jaemin, Kim Byung Sam, Chang Hae Wone, Lee Yoonki
Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, Seoul 137-040, Republic of Korea.
J Clin Anesth. 2005 Aug;17(5):334-8. doi: 10.1016/j.jclinane.2004.08.007.
The objective of this study was to evaluate the effectiveness of a modified Macintosh blade for reducing the chances of directly contacting the teeth and providing a satisfactory laryngoscopic view during laryngoscopies by novice laryngoscopists.
This is a prospective clinical comparison study.
The study took place at an operating room of a university hospital.
Seventy-two patients with American Society of Anesthesiologists physical statuses I and II, aged 16 to 64 years, who were scheduled for elective surgery requiring general anesthesia with endotracheal tube placement participated in this study.
Laryngoscopy was performed twice on each patient, once with a regular Macintosh no. 3 blade and once with a blade in which the flange was partially removed.
As an indirect parameter for anticipating potential dental injury during laryngoscopy, the perpendicular distance from the tip of the maxillary central incisor to the flange of each blade (the blade-tooth distance) was measured when a novice laryngoscopist lifted up the laryngoscope and visualized the glottis. We compared the blade-tooth distances, the chances of directly contacting the tooth, laryngoscopic views, and the subjective feeling of difficulty in handling the laryngoscope between the 2 blades.
Blade-tooth distance varied significantly between the 2 blades: the median/interquartile range was 1.2/2.3 mm vs 3.0/4.3 mm for the regular Macintosh no. 3 and the modified blade, respectively (P<.01). The modified blade was associated with decreased chances of directly contacting the teeth (P<.05). In addition, the modified blade provided a better laryngoscopic view than did the regular blade (P<.01). Most novice laryngoscopists felt that laryngoscopy with the modified blade was significantly easier than that with the regular Macintosh blade (P<.01).
The modified Macintosh blade used in this study proved to be a useful device for training novice laryngoscopists with respect to procedure effectiveness and patient safety.
本研究的目的是评估一种改良型麦金托什喉镜叶片在减少新手喉镜检查者喉镜检查期间直接接触牙齿的几率以及提供满意喉镜视野方面的有效性。
这是一项前瞻性临床对照研究。
研究在一家大学医院的手术室进行。
72例美国麻醉医师协会身体状况分级为I级和II级、年龄在16至64岁之间、计划接受需要气管插管全身麻醉的择期手术的患者参与了本研究。
对每位患者进行两次喉镜检查，一次使用常规的3号麦金托什喉镜叶片，一次使用部分去除侧翼的叶片。
作为预测喉镜检查期间潜在牙齿损伤的间接参数，当新手喉镜检查者抬起喉镜并观察到声门时，测量上颌中切牙尖端到每个叶片侧翼的垂直距离（叶片 - 牙齿距离）。我们比较了两种叶片之间的叶片 - 牙齿距离、直接接触牙齿的几率、喉镜视野以及操作喉镜时的主观困难感受。
两种叶片之间的叶片 - 牙齿距离差异显著：常规3号麦金托什喉镜叶片和改良叶片的中位数/四分位数间距分别为1.2/2.3毫米和3.0/4.3毫米（P<0.01）。改良叶片与直接接触牙齿的几率降低相关（P<0.05）。此外，改良叶片提供的喉镜视野比常规叶片更好（P<0.01）。大多数新手喉镜检查者认为使用改良叶片进行喉镜检查比使用常规麦金托什喉镜叶片明显更容易（P<0.01）。
本研究中使用的改良型麦金托什喉镜叶片在操作有效性和患者安全方面被证明是培训新手喉镜检查者的有用工具。
Zotero 插件