Marrel J, Blanc C, Frascarolo P, Magnusson L
University Hospital, Department of Anaesthesiology, Lausanne, Switzerland.
Eur J Anaesthesiol. 2007 Dec;24(12):1045-9. doi: 10.1017/S0265021507000889. Epub 2007 Jul 4.
Tracheal intubation may be more difficult in morbidly obese patients (body mass index >35 kg m(-2)) than in the non-obese. Recently, new video-assisted intubation devices have been developed. After some experience with videolaryngoscopy, we hypothesized that it could improve the laryngoscopic view in this specific population and therefore facilitate intubation. The aim of this study was to assess the benefit of a videolaryngoscope on the grade of laryngoscopy in morbid obesity.
We studied 80 morbidly obese patients undergoing bariatric surgery. They were randomly assigned to one of two groups. One group was intubated with the help of the videolaryngoscope and in the control group the screen of the videolaryngoscope was hidden to the intubating anaesthesiologist. The primary end-point of the study was to assess in both groups the Cormack and Lehane direct and indirect grades of laryngoscopy. The duration of intubation, the number of attempts needed as well as the minimal SPO2 reached during the intubation process were measured.
Grade of laryngoscopy was significantly lower with the videolaryngoscope compared with the direct vision (P < 0.001). When the grade of laryngoscopy was higher than one with the direct laryngoscopy (n = 30), it was lower in 28 cases with the videolaryngoscope and remained the same only in two cases (P < 0.001). The minimal SPO2 reached during the intubation was higher with the videolaryngoscope but it did not reach statistical significance.
In morbidly obese patients, the use of the videolaryngoscope significantly improves the visualization of the larynx and thereby facilitates intubation.
与非肥胖患者相比，病态肥胖患者（体重指数>35 kg/m²）的气管插管可能更困难。近年来，新型视频辅助插管设备已被研发出来。在积累了一些视频喉镜的使用经验后，我们推测它可以改善这一特定人群的喉镜视野，从而便于插管。本研究的目的是评估视频喉镜对病态肥胖患者喉镜分级的益处。
我们研究了80例接受减肥手术的病态肥胖患者。他们被随机分为两组。一组在视频喉镜的帮助下进行插管，对照组中视频喉镜的屏幕对实施插管的麻醉医生隐藏起来。本研究的主要终点是评估两组患者的直接喉镜和间接喉镜的Cormack和Lehane分级。测量插管持续时间、所需尝试次数以及插管过程中达到的最低血氧饱和度。
与直接喉镜相比，视频喉镜的喉镜分级显著更低（P<0.001）。当直接喉镜检查的喉镜分级高于一级时（n = 30），视频喉镜检查时28例分级更低，仅2例保持不变（P<0.001）。视频喉镜检查时插管过程中达到的最低血氧饱和度更高，但未达到统计学意义。
在病态肥胖患者中，使用视频喉镜可显著改善喉部视野，从而便于插管。
